Provider Demographics
NPI:1124024096
Name:CHUBE, DAVID DAMARET (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DAMARET
Last Name:CHUBE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3229 BROADWAY
Mailing Address - Street 2:STE 111
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46409-1040
Mailing Address - Country:US
Mailing Address - Phone:219-887-4402
Mailing Address - Fax:219-887-4415
Practice Address - Street 1:3229 BROADWAY
Practice Address - Street 2:STE 111
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46409-1040
Practice Address - Country:US
Practice Address - Phone:219-887-4402
Practice Address - Fax:219-887-4415
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01038347173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01038347OtherLICENSE NUMBER
IN01038347OtherLICENSE NUMBER
INE71060Medicare UPIN
IN132490AMedicare ID - Type UnspecifiedMEDICARE ID NUMBER