Provider Demographics
NPI:1346559234
Name:ABBOTT, CHAD EDWARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:EDWARD
Last Name:ABBOTT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 402 BOX 0506
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180-0006
Mailing Address - Country:US
Mailing Address - Phone:314-590-5122
Mailing Address - Fax:
Practice Address - Street 1:DR HITZELBERGER STRASSE
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180
Practice Address - Country:US
Practice Address - Phone:314-590-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6638183500000X, 286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No286500000XHospitalsMilitary Hospital