Organization
MICHAEL W. CHANCELLOR, M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W CHANCELLOR M.D. (OWNER)
(479) 831-9545
Entity
Organization
Contact information
Practice address
3425 S ATLANTIC AVE APT 906, DAYTONA BEACH SHORES, FL 32118-6363
(479) 831-9545
Mailing address
3425 S ATLANTIC AVE APT 906, DAYTONA BEACH SHORES, FL 32118-6363
(479) 831-9545
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
E-5444
AR
Other
Enumeration date
12/13/2007
Last updated
01/20/2010
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