MEDICARE: DEBORAH J CHAMBERS MD

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	207Q00000X	Family Medicine Physician	74480	GA
2	207Q00000X	Family Medicine Physician	34703	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	001478806	OTHER	PA	BS OF PA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558365049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH J CHAMBERS MD

Provider Business Mailing Address
First Line	:	14606 SW 70TH ST
Second Line	:
City	:	ARCHER
State	:	FL
Zip	:	32618-5804
Country	:	US
Telephone Number	:	843-473-3311
Fax Number	:	843-706-3350

Provider Business Practice Location Address
First Line	:	57 LAKE LINDEN LN
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-6423
Country	:	US
Telephone Number	:	843-683-1820
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	02/26/2019

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