Provider Demographics
NPI:1750661203
Name:CHESAPEAKE WEIGHT LOSS CONSULTANTS PLLC
Entity Type:Organization
Organization Name:CHESAPEAKE WEIGHT LOSS CONSULTANTS PLLC
Other - Org Name:CHESAPEAKE WEIGHT LOSS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:CHASTANET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-312-9444
Mailing Address - Street 1:CHESAPEAKE WEIGHT LOSS CONSULTANTS, PLLC
Mailing Address - Street 2:221 MOUNT PLEASANT ROAD SUITE A-1
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-4155
Mailing Address - Country:US
Mailing Address - Phone:757-312-9444
Mailing Address - Fax:757-447-3500
Practice Address - Street 1:680 KINGSBOROUGH SQ
Practice Address - Street 2:SUITE D
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4988
Practice Address - Country:US
Practice Address - Phone:757-312-9444
Practice Address - Fax:757-447-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-27
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043938207RB0002X
VA0101222153208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty