Healthcare Provider Details

I. General information

NPI: 1063444560
Provider Name (Legal Business Name): CHESTERFIELD KIDNEY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N 6TH AVE
HOPEWELL VA
23860-2618
US

IV. Provider business mailing address

PO BOX 11768
RICHMOND VA
23230-0168
US

V. Phone/Fax

Practice location:
  • Phone: 804-452-4546
  • Fax: 804-452-4549
Mailing address:
  • Phone: 804-353-4000
  • Fax: 804-213-9783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number0101239716
License Number StateVA

VIII. Authorized Official

Name: DR. ANWAR AHMED
Title or Position: PRESIDENT
Credential: M.D.
Phone: 804-452-4546