Provider Demographics
NPI:1811966658
Name:CHATHAM MEDICAL SPECIALISTS PA
Entity type:Organization
Organization Name:CHATHAM MEDICAL SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:919-663-3360
Mailing Address - Street 1:421 N HOLLY AVE
Mailing Address - Street 2:PO BOX 689
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344
Mailing Address - Country:US
Mailing Address - Phone:919-663-3360
Mailing Address - Fax:919-663-2874
Practice Address - Street 1:421 N HOLLY AVE
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344
Practice Address - Country:US
Practice Address - Phone:919-663-3360
Practice Address - Fax:919-663-2874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
02102OtherBCBS
NC79021202Medicaid
NC79021202Medicaid