Provider Demographics
NPI:1790706224
Name:CHAMBERS, DANA (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:CHAMBERS
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 249
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-0249
Mailing Address - Country:US
Mailing Address - Phone:828-465-2231
Mailing Address - Fax:
Practice Address - Street 1:212 29TH AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-1130
Practice Address - Country:US
Practice Address - Phone:828-485-2762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01081188A207Q00000X
RIMD16441207Q00000X
VA0101265788207Q00000X
TXR9733207Q00000X
NC9800805207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11511OtherBLUE CROSS BLUE SHIELD
NCCN8132OtherMEDICARE RAILROAD
NC891234EMedicaid
NC2257970AMedicare PIN
NC11511OtherBLUE CROSS BLUE SHIELD
NCCN8132OtherMEDICARE RAILROAD
NC2257970Medicare ID - Type Unspecified