MEDICARE: DR. DAVID CHADBOURNE 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	208800000X	Urology Physician	101371-85	WI
2	208800000X	Urology Physician	81829	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	10444433	OTHER	CAQH

General Provider Information

NPI Number	:	1740277011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID CHADBOURNE MD

Provider Business Mailing Address
First Line	:	PO BOX 887
Second Line	:
City	:	ABBEVILLE
State	:	SC
Zip	:	29620-0887
Country	:	US
Telephone Number	:	864-366-7902
Fax Number	:	864-366-6062

Provider Business Practice Location Address
First Line	:	135 PROFESSIONAL PARK DR
Second Line	:
City	:	SENECA
State	:	SC
Zip	:	29678-2558
Country	:	US
Telephone Number	:	864-882-8074
Fax Number	:

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

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	06/18/2025

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Directions to “ DR. DAVID CHADBOURNE MD” Practice Location

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