Provider Demographics
NPI:1285654905
Name:CHAVIS, RICHARD M (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:CHAVIS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6430 ROCKLEDGE DR
Mailing Address - Street 2:270
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1805
Mailing Address - Country:US
Mailing Address - Phone:301-493-9600
Mailing Address - Fax:301-493-9235
Practice Address - Street 1:6430 ROCKLEDGE DR
Practice Address - Street 2:270
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1805
Practice Address - Country:US
Practice Address - Phone:301-493-9600
Practice Address - Fax:301-493-9235
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2009-11-16
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Provider Licenses
StateLicense IDTaxonomies
MDD0019000207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC61437Medicare UPIN