Provider Demographics
NPI:1225194277
Name:CHATHAM PEDIATRICS
Entity Type:Organization
Organization Name:CHATHAM PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDMUND
Authorized Official - Last Name:SCHWANKL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-742-2209
Mailing Address - Street 1:1002 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-3042
Mailing Address - Country:US
Mailing Address - Phone:919-742-2209
Mailing Address - Fax:919-742-1310
Practice Address - Street 1:1002 W 3RD ST
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-3042
Practice Address - Country:US
Practice Address - Phone:919-742-2209
Practice Address - Fax:919-742-1310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18227208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8902644Medicaid
NC1003130121OtherNPI
NC1952526667OtherNPI
NC1760555494OtherNPI
NC8902644Medicaid
C86353Medicare UPIN