Individual
CHAD D LAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 MORRIS ST, SUITE 201, CHARLESTON, WV 25301-1842
(304) 388-7700
(304) 388-7755
Mailing address
300 CORPORATE CENTER DRIVE, SCOTT DEPOT, WV 25560
(304) 691-6710
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
24375
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932360955
—
VA
Enumeration date
06/23/2008
Last updated
12/08/2021
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