Provider Demographics
NPI:1801960935
Name:CENTER FOR CHEST DISEASE LLC
Entity type:Organization
Organization Name:CENTER FOR CHEST DISEASE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHOMIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-694-5861
Mailing Address - Street 1:501 W 7TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4589
Mailing Address - Country:US
Mailing Address - Phone:301-694-5861
Mailing Address - Fax:301-694-0927
Practice Address - Street 1:501 W 7TH ST STE D
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4589
Practice Address - Country:US
Practice Address - Phone:301-694-5861
Practice Address - Fax:301-694-0927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD470PMedicare PIN