Healthcare Provider Details

I. General information

NPI: 1982153755
Provider Name (Legal Business Name): ALDEN E CHESNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 09/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250E MARSHALL ST DEPARTMENT OF PATHOLOGY
RICHMOND VA
23291-1734
US

IV. Provider business mailing address

1250 E MARSHALL ST DEPARTMENT OF PATHOLOGY
RICHMOND VA
23298-5023
US

V. Phone/Fax

Practice location:
  • Phone: 804-358-6100
  • Fax: 804-342-7619
Mailing address:
  • Phone: 804-828-9746
  • Fax: 804-828-9749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number0101237001
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number0101237001
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: