Provider Demographics
NPI:1649398462
Name:CHESTER PEDIATRICS
Entity Type:Organization
Organization Name:CHESTER PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-796-2300
Mailing Address - Street 1:4707 BUCKINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-4261
Mailing Address - Country:US
Mailing Address - Phone:804-796-2300
Mailing Address - Fax:804-751-4815
Practice Address - Street 1:4707 BUCKINGHAM CT
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-4261
Practice Address - Country:US
Practice Address - Phone:804-796-2300
Practice Address - Fax:804-751-4815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty