Provider Demographics
NPI:1558697128
Name:CHALSON, RICHARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:CHALSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 NORTHRIDGE DR
Mailing Address - Street 2:VOLUNTEERS IN MEDICINE CLINIC
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-3764
Mailing Address - Country:US
Mailing Address - Phone:843-681-6612
Mailing Address - Fax:
Practice Address - Street 1:15 NORTHRIDGE DR
Practice Address - Street 2:VOLUNTEERS IN MEDICINE CLINIC
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-3764
Practice Address - Country:US
Practice Address - Phone:843-681-6612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28463207V00000X
NY121383207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology