Healthcare Provider Details

I. General information

NPI: 1588649206
Provider Name (Legal Business Name): STEVEN LAWRENCE CHAMBERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 S MAIN ST # 2
DAYTON OH
45409-2698
US

IV. Provider business mailing address

1520 S MAIN ST # 2
DAYTON OH
45409-2698
US

V. Phone/Fax

Practice location:
  • Phone: 937-461-5815
  • Fax: 937-461-5815
Mailing address:
  • Phone: 937-461-5815
  • Fax: 937-461-5815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35087818
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35087818
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: