Provider Demographics
NPI:1255580361
Name:CHALISE, SOM NATH (MD)
Entity type:Individual
Prefix:
First Name:SOM
Middle Name:NATH
Last Name:CHALISE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-316-5800
Mailing Address - Fax:757-534-5491
Practice Address - Street 1:12200 WARWICK BLVD STE 290
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601
Practice Address - Country:US
Practice Address - Phone:757-534-5454
Practice Address - Fax:757-534-5491
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2019-08-28
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Provider Licenses
StateLicense IDTaxonomies
NC201487207RP1001X
VA0101266927207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease