Healthcare Provider Details

I. General information

NPI: 1225237456
Provider Name (Legal Business Name): CHATHAM FAMILY MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 11/22/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13908 US HIGHWAY 29
CHATHAM VA
24531-3669
US

IV. Provider business mailing address

13908 US HIGHWAY 29
CHATHAM VA
24531-3669
US

V. Phone/Fax

Practice location:
  • Phone: 434-432-0216
  • Fax: 434-432-3425
Mailing address:
  • Phone: 434-432-0216
  • Fax: 434-432-3425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MINESH R SHAH
Title or Position: PRESIDENT/PHYSICIAN
Credential: M.D.
Phone: 434-432-0216