Provider Demographics
NPI:1376705517
Name:PRICE, CHILESHE N (MD)
Entity Type:Individual
Prefix:DR
First Name:CHILESHE
Middle Name:N
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHILESHE
Other - Middle Name:
Other - Last Name:NKONDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3400 CIVIC CENTER BLVD
Mailing Address - Street 2:2 EAST
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-615-4949
Mailing Address - Fax:203-432-7289
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:2 EAST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-615-4949
Practice Address - Fax:203-688-5599
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD437706207R00000X
CT049397390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine