Healthcare Provider Details

I. General information

NPI: 1487391561
Provider Name (Legal Business Name): CHADANE DAVID ROMONE THOMPSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date: 02/17/2023
Reactivation Date: 03/20/2023

III. Provider practice location address

5115 CENTRE AVE
PITTSBURGH PA
15232-1301
US

IV. Provider business mailing address

3600 FORBES AVE FORBES TOWER - PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213-3410
US

V. Phone/Fax

Practice location:
  • Phone: 412-648-6575
  • Fax: 412-648-6579
Mailing address:
  • Phone: 412-647-6340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT236981
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: