Provider Demographics
NPI:1881945467
Name:CHEMELL, LUIGI WILTON (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:LUIGI
Middle Name:WILTON
Last Name:CHEMELL
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3259 CATLIN AVE
Mailing Address - Street 2:
Mailing Address - City:QUANTICO
Mailing Address - State:VA
Mailing Address - Zip Code:22134-5109
Mailing Address - Country:US
Mailing Address - Phone:703-784-2062
Mailing Address - Fax:
Practice Address - Street 1:2603 LOWER GAINESVILLE ROAD
Practice Address - Street 2:
Practice Address - City:STENNIS CTR
Practice Address - State:MS
Practice Address - Zip Code:39529-5109
Practice Address - Country:US
Practice Address - Phone:228-813-4310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
LA329650363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical