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General NPI Number Information
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NPI Number | 1265752547
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Entity Type | Individual
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Provider Name | GREGORY THOMAS CHESNUT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | WALTER REED NATIONAL MILITARY MEDICAL CENTER 4954 NORT PALMER RD
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City | BETHESDA
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State | MD
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Zip | 20889-5630
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Country | US
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Telephone | 301-319-2900
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Fax | 301-319-2901
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Provider Business Mailing Address
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Address Line | WRNMMC/CPDR 4954 NORTH PALMER RD
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City | BETHESDA
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State | MD
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Zip | 20889-5630
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Country | US
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Telephone | 301-312-7770
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Fax |
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0101250165
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License Number State | VA
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