Provider Demographics
NPI:1760684831
Name:PAUL N CHOMIAK MD LLC
Entity Type:Organization
Organization Name:PAUL N CHOMIAK MD LLC
Other - Org Name:CENTER FOR CHEST DISEASE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHOMIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-714-4340
Mailing Address - Street 1:501 W 7TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4586
Mailing Address - Country:US
Mailing Address - Phone:301-694-5861
Mailing Address - Fax:301-694-0927
Practice Address - Street 1:501 W 7TH ST STE D
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4589
Practice Address - Country:US
Practice Address - Phone:301-694-5861
Practice Address - Fax:301-694-0927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060042208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD184NMedicare PIN