Provider Demographics
NPI:1104010529
Name:CHAIT, DAVID JACOB (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JACOB
Last Name:CHAIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 ROLLING CT
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4040
Mailing Address - Country:US
Mailing Address - Phone:301-654-2181
Mailing Address - Fax:
Practice Address - Street 1:3401 ROLLING CT
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4040
Practice Address - Country:US
Practice Address - Phone:301-654-2181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010306962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB49228Medicare UPIN