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General NPI Number Information
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NPI Number | 1407152697
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Entity Type | Individual
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Provider Name | CHADWIN CARTER ELGERSMA D.O
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Gender | Male
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 08/26/2019
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Provider Practice Location Address
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Address Line | 2157 MAIN ST
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City | BUFFALO
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State | NY
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Zip | 14214
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Country | US
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Telephone | 716-836-7510
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Fax | 716-832-3540
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Provider Business Mailing Address
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Address Line | 3871 HARLEM RD STE 202
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City | BUFFALO
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State | NY
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Zip | 14215-1946
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Country | US
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Telephone | 716-836-7510
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Fax | 716-832-3540
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 263976
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 263976-1
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License Number State | NY
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