Basic Information
Provider Information
NPI: 1396892279
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHESTER
FirstName: MICHAEL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1310 24TH AVE S
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372122637
CountryCode: US
TelephoneNumber: 6153274751
FaxNumber:  
Practice Location
Address1: 1310 24TH AVE S
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372122637
CountryCode: US
TelephoneNumber: 6153274751
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/04/2007
LastUpdateDate: 02/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD0000040520TNY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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