Provider Demographics
NPI:1225237456
Name:CHATHAM FAMILY MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:CHATHAM FAMILY MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MINESH
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-432-0216
Mailing Address - Street 1:13908 US HIGHWAY 29
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:VA
Mailing Address - Zip Code:24531-3669
Mailing Address - Country:US
Mailing Address - Phone:434-432-0216
Mailing Address - Fax:434-432-3425
Practice Address - Street 1:13908 US HIGHWAY 29
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:VA
Practice Address - Zip Code:24531-3669
Practice Address - Country:US
Practice Address - Phone:434-432-0216
Practice Address - Fax:434-432-3425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6039620001Medicare NSC