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MASON CHASTEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
619 19TH ST S, BIRMINGHAM, AL 35249
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2422
SC
363A00000X
Physician Assistant
Primary
PA.1306
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2691PA
SC
Enumeration date
09/23/2015
Last updated
07/19/2018
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