Individual
CHARLES H CHESNUT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
MD00011188
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110075127
RAILROAD MEDICARE
WA
05
—
1152206
—
WA
01
—
1153
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/27/2006
Last updated
05/30/2008
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