Provider Demographics
NPI:1538171061
Name:CHESNUTT, DAVID A (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:CHESNUTT
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5133 BIOINFORMATICS BUILDING CB 7040
Mailing Address - Street 2:UNC-CH DEPARTMENT OF OPHTHALMOLOGY
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7040
Mailing Address - Country:US
Mailing Address - Phone:919-966-5296
Mailing Address - Fax:919-966-1908
Practice Address - Street 1:103 COX BLVD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9478
Practice Address - Country:US
Practice Address - Phone:919-734-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9801205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912108Medicaid
NC8912108Medicaid
NC2273930AMedicare PIN