Provider Demographics
NPI:1780669077
Name:SANE, DAVID CHESTER (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHESTER
Last Name:SANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:127 MCCLANAHAN ST SW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1728
Mailing Address - Country:US
Mailing Address - Phone:540-982-8204
Mailing Address - Fax:540-224-1059
Practice Address - Street 1:127 MCCLANAHAN ST SW
Practice Address - Street 2:SUITE 300
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1728
Practice Address - Country:US
Practice Address - Phone:540-982-8204
Practice Address - Fax:540-224-1059
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC29390207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
60067876OtherRR MEDICARE
5678OtherPARTNERS
74481OtherBCBS
SCQ29390Medicaid
38820OtherMEDCOST
WV1805397000Medicaid
4620331OtherAETNA
VA6078044Medicaid
NC8974481Medicaid
38820OtherMEDCOST
SCQ29390Medicaid