Individual
ANDREW PARKE CHASTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
705 RILEY HOSPITAL DR, RR 208, INDIANAPOLIS, IN 46202
(317) 274-4715
(317) 274-2065
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001065A
IN
363A00000X
Physician Assistant
PA19750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300012406
—
IN
Enumeration date
06/12/2008
Last updated
05/15/2018
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