Provider Demographics
NPI:1023048931
Name:CHESNEY, MARK ALAN (HMC/IDC, US NAVY)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ALAN
Last Name:CHESNEY
Suffix:
Gender:M
Credentials:HMC/IDC, US NAVY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3573 FOREST HAVEN LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5129
Mailing Address - Country:US
Mailing Address - Phone:843-476-8979
Mailing Address - Fax:
Practice Address - Street 1:3573 FOREST HAVEN LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5129
Practice Address - Country:US
Practice Address - Phone:843-476-8979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman