Provider Demographics
NPI:1588826713
Name:MCCHESNEY, GUY H
Entity Type:Individual
Prefix:MR
First Name:GUY
Middle Name:H
Last Name:MCCHESNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 MELBOURNE ST # 1
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-2727
Mailing Address - Country:US
Mailing Address - Phone:207-415-1869
Mailing Address - Fax:
Practice Address - Street 1:449 FOREST AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2029
Practice Address - Country:US
Practice Address - Phone:207-415-1869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME5633205171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor