Provider Demographics
NPI:1083054928
Name:PAYNE, CHLOE ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHLOE
Middle Name:ANNE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:ANNE
Other - Last Name:ETZLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:219 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1519
Mailing Address - Country:US
Mailing Address - Phone:215-762-5550
Mailing Address - Fax:
Practice Address - Street 1:2000 FOULK RD STE A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3642
Practice Address - Country:US
Practice Address - Phone:302-475-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10024193207N00000X
IL036.143253207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty