Provider Demographics
NPI:1770678849
Name:CHEST ASSOCIATES
Entity Type:Organization
Organization Name:CHEST ASSOCIATES
Other - Org Name:JULIAN CRAIG MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-563-2844
Mailing Address - Street 1:2113 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-4227
Mailing Address - Country:US
Mailing Address - Phone:202-563-2844
Mailing Address - Fax:202-563-2337
Practice Address - Street 1:1328 SOUTHERN AVE SE
Practice Address - Street 2:STE 312
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4689
Practice Address - Country:US
Practice Address - Phone:202-563-2844
Practice Address - Fax:202-563-2337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCS9911160174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G92367Medicare UPIN
491200Medicare ID - Type UnspecifiedMDCR PROV #