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NPI Code Detail

MEDICARE: CHANCELLOR PEDIATRICS, P.C.

MEDICARE: CHANCELLOR PEDIATRICS, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician0101228664VA

General Provider Information

NPI Number : 1649215948
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHANCELLOR PEDIATRICS, P.C.
Provider Business Mailing Address
First Line : 12006 KILARNEY DR
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22407-7207
Country : US
Telephone Number : 540-786-9771
Fax Number : 540-548-8806
Provider Business Practice Location Address
First Line : 12006 KILARNEY DR
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22407-7207
Country : US
Telephone Number : 540-786-9771
Fax Number : 540-548-8806
Authorized Official
Title or Position : PHYSICIAN/OWNER
Name : CHARLES AMORY
Credential : M.D.
Telephone Number : 540-786-9771
Provider Enumeration Date : 06/19/2006
Last Update Date : 08/22/2020

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Directions to “CHANCELLOR PEDIATRICS, P.C. ” Practice Location

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