Provider Demographics
NPI:1811949399
Name:CHADWIN, RICHARD JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:CHADWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 HUDSON CT
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-7146
Mailing Address - Country:US
Mailing Address - Phone:707-849-6533
Mailing Address - Fax:
Practice Address - Street 1:690 HUDSON CT
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476
Practice Address - Country:US
Practice Address - Phone:707-849-6533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG272742084P0800X, 2084P0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F14457Medicare UPIN
00G272740Medicare ID - Type Unspecified