Provider Demographics
NPI:1932206125
Name:CHESAPEAKE HOSPITALISTS, PC
Entity Type:Organization
Organization Name:CHESAPEAKE HOSPITALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:FULP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-312-6585
Mailing Address - Street 1:P.O. BOX 16180
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23328-6180
Mailing Address - Country:US
Mailing Address - Phone:757-312-6585
Mailing Address - Fax:757-222-1708
Practice Address - Street 1:736 N. BATTLEFIELD BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4941
Practice Address - Country:US
Practice Address - Phone:757-312-6585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056073207P00000X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA139607OtherANTHEM
VA005857643Medicaid
VACH8520OtherRAILROAD MEDICARE
VAC06905Medicare PIN