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NPI 1437682564

NPI 1437682564 : CHANDLER SCOTT BROBST MD : MUNCIE, IN

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General NPI Number Information
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    NPI Number           |    1437682564
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    Entity Type          |    Individual 
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    Provider Name        |    CHANDLER SCOTT BROBST MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/05/2017
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    Last Update Date     |    02/07/2024
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Provider Practice Location Address
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    Address Line         |    2598 W WHITE RIVER BLVD 
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    City                 |    MUNCIE
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    State                |    IN
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    Zip                  |    47303-5251
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    Country              |    US
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    Telephone            |    765-702-2817
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    Fax                  |    765-222-2198
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Provider Business Mailing Address
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    Address Line         |    250 N SHADELAND AVE 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46219-4959
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    Country              |    US
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    Telephone            |    
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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        |    207PS0010X
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    Taxonomy Name        |    Sports Medicine (Emergency Medicine) Physician
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    License Number       |    01089633A
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    License Number State |    IN
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