Organization
JOSE D CHAVEZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LENORE CHAVEZ (OFFICE MANAGER)
(803) 772-4172
Entity
Organization
Contact information
Practice address
17 SURREY CT, COLUMBIA, SC 29212-3139
(803) 772-4172
Mailing address
17 SURREY CT, COLUMBIA, SC 29212-3139
(803) 772-4172
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8636
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
086365
—
SC
Enumeration date
01/30/2008
Last updated
10/28/2008
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