Basic Information
Provider Information
NPI: 1649273897
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAMBERS
FirstName: DAVID
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 200149
Address2:  
City: ANCHORAGE
State: AK
PostalCode: 995200149
CountryCode: US
TelephoneNumber: 9075613211
FaxNumber: 9075627547
Practice Location
Address1: 247 N FIREWEED ST
Address2: SUITE B
City: SOLDOTNA
State: AK
PostalCode: 996697540
CountryCode: US
TelephoneNumber: 9075613211
FaxNumber: 9075627547
Other Information
ProviderEnumerationDate: 05/23/2005
LastUpdateDate: 05/09/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XMD23541TNN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0000X4447AKY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

ID Information
IDTypeStateIssuerDescription
06006422501 RAILROAD MEDICARE PINOTHER
101000905AK MEDICAID
401489401TNBLUE CROSS BLUE SHIELD TNOTHER
306790105TN MEDICAID


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