MEDICARE: MARVIN CHADAB MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	0101028798	VA
2	207N00000X	Dermatology Physician	D0020477	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2803515	OTHER	TX	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8084	OTHER	MD	GHMSI BLUE CROSS

General Provider Information

NPI Number	:	1467552729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARVIN CHADAB MD PA

Provider Business Mailing Address
First Line	:	6130 OXON HILL RD
Second Line	:	SUITE 201
City	:	OXON HILL
State	:	MD
Zip	:	20745-3168
Country	:	US
Telephone Number	:	301-567-2774
Fax Number	:	301-567-4498

Provider Business Practice Location Address
First Line	:	6130 OXON HILL RD
Second Line	:	SUITE 201
City	:	OXON HILL
State	:	MD
Zip	:	20745-3168
Country	:	US
Telephone Number	:	301-567-2774
Fax Number	:	301-567-4498

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARVIN CHADAB
Credential	:	MD
Telephone Number	:	301-567-2774

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	11/01/2007

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