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Individual

MARTHA J CHESNUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
91 ENTERPRISE DR, ROCKY MOUNT, NC 27804-9590
(252) 451-3200
(252) 937-3107
Mailing address
PO BOX 7200, ROCKY MOUNT, NC 27804-0200
(252) 937-0200
(252) 451-0056

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200300016
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
134EC
BCBSNC
NC
01
3822785
CIGNA HEALTHCARE
NC
05
89134EC
NC
01
DC6521
MEDCOST
NC
01
P00033418
RAILROAD MEDICARE
NC
Enumeration date
09/06/2005
Last updated
02/20/2019
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