Provider Demographics
NPI:1841920170
Name:VARELA CHINCHILLA, CARLOS DANIEL (MD)
Entity type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:DANIEL
Last Name:VARELA CHINCHILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4200 WISCONSIN AVE NW
Mailing Address - Street 2:4TH FLOOR, DEPARTMENT OF PEDIATRICS
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-243-3400
Mailing Address - Fax:202-243-3234
Practice Address - Street 1:4200 WISCONSIN AVE NW
Practice Address - Street 2:4TH FLOOR, DEPARTMENT OF PEDIATRICS
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-243-3400
Practice Address - Fax:202-243-3234
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMTL500001542390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program