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General NPI Number Information
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NPI Number | 1104028919
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Entity Type | Individual
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Provider Name | WILLIAM M CHASANOV II D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1535 SAVANNAH RD
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City | LEWES
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State | DE
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Zip | 19958-1611
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Country | US
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Telephone | 302-645-3232
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Fax | 302-645-3198
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Provider Business Mailing Address
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Address Line | 1515 SAVANNAH RD
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City | LEWES
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State | DE
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Zip | 19958-1675
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Country | US
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Telephone | 302-645-3499
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Fax | 302-644-4830
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C7-0003773
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 25MB09331000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | C7-0003733
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License Number State | DE
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