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Individual

CHARLES H CHESNUT III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
UWMC-ROOSEVELT, 4245 ROOSEVELT WAY NE, SEATTLE, WA 98105-4740
(206) 598-4288
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095

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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