Provider Demographics
NPI:1609828706
Name:CHANSON, RHONDA S (MD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:S
Last Name:CHANSON
Suffix:
Gender:F
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:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:2270 ASHLEY CROSSING DR STE 135
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5732
Practice Address - Country:US
Practice Address - Phone:843-556-7942
Practice Address - Fax:843-556-7946
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21597207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00727237OtherRAILROAD MEDICARE ID-RSFPN
SC110206110OtherRR MEDICARE
SC110232035OtherRAILROAD MEDICARE
SC215975Medicaid
SCGP1197Medicaid
SCP00727237OtherRAILROAD MEDICARE ID-RSFPN
SCH177064942Medicare PIN
SC1477503787Medicare PIN
SCGP1197Medicaid
SCH17706Medicare UPIN
SC215975Medicaid