Individual
DAVID REGINALD CHISHOLM, MD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 E SWANSON #3, WASILLA, AK 99654
(907) 357-6180
(907) 357-6184
Mailing address
500 E SWANSON #3, WASILLA, AK 99654
(907) 357-6180
(907) 357-6184
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AK4075
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD12811
—
AK
Enumeration date
09/20/2006
Last updated
07/08/2007
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