Provider Demographics
NPI:1467415620
Name:CHESTER, RALPH L (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:L
Last Name:CHESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2215 LANGHORNE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1121
Mailing Address - Country:US
Mailing Address - Phone:434-948-4831
Mailing Address - Fax:434-948-4855
Practice Address - Street 1:2215 LANGHORNE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1121
Practice Address - Country:US
Practice Address - Phone:434-948-4831
Practice Address - Fax:434-948-4855
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA088174400000X
VA01012389962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945441Medicaid
VA187680OtherANTHEM
VA004945441Medicaid
VA187680OtherANTHEM