MEDICARE: RICHARD ALAN CHEFETZ M.D.

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
1	2084P0800X	Psychiatry Physician	MD18195	DC

General Provider Information

NPI Number	:	1780648832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD ALAN CHEFETZ M.D.

Provider Business Mailing Address
First Line	:	4612 49TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-4321
Country	:	US
Telephone Number	:	202-966-0224
Fax Number	:	202-244-5676

Provider Business Practice Location Address
First Line	:	4612 49TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-4321
Country	:	US
Telephone Number	:	202-966-0224
Fax Number	:	202-244-5676

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	11/29/2007

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