Provider Demographics
NPI:1255513636
Name:CHESTNUT, MEEGAN CHRISTA (MD)
Entity type:Individual
Prefix:DR
First Name:MEEGAN
Middle Name:CHRISTA
Last Name:CHESTNUT
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 1:7500 HANOVER PKWY
Mailing Address - Street 2:STE 105B
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2091
Mailing Address - Country:US
Mailing Address - Phone:803-429-9002
Mailing Address - Fax:
Practice Address - Street 1:5450 KNOLL NORTH DR
Practice Address - Street 2:STE 260
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2373
Practice Address - Country:US
Practice Address - Phone:410-964-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD072639207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD225732ZDDB - 149619Medicare PIN
MD225732YVZ - C03895Medicare PIN