Provider Demographics
NPI:1851393219
Name:CHAVES, GERMAN (MD)
Entity Type:Individual
Prefix:
First Name:GERMAN
Middle Name:
Last Name:CHAVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8159 CALLE CONCORDIA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1551
Mailing Address - Country:US
Mailing Address - Phone:787-259-8303
Mailing Address - Fax:787-259-8303
Practice Address - Street 1:8159 CALLE CONCORDIA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1551
Practice Address - Country:US
Practice Address - Phone:787-259-8303
Practice Address - Fax:787-259-8303
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR66552085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE14373Medicare UPIN