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General NPI Number Information
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NPI Number | 1245914449
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Entity Type | Organization
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Legal Business Name | CHASTAIN INTEGRATIVE MEDICINE LLC
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Dates
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Enumeration Date | 06/09/2023
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Last Update Date | 06/09/2023
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Provider Practice Location Address
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Address Line | 80 W WIEUCA RD NE STE 201
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City | ATLANTA
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State | GA
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Zip | 30342-3243
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Country | US
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Telephone | 470-443-8988
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Fax | 404-975-3191
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Provider Business Mailing Address
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Address Line | 4959 NORTHSIDE DR
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City | ATLANTA
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State | GA
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Zip | 30327-4419
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Country | US
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Telephone | 616-308-1701
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Fax | 404-975-3191
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. CONTESSA D METCALFE
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Credential | MD
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Telephone | 616-308-1701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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