MEDICARE: ALAIN ANTHONY CHAMOUN D.O.

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	207R00000X	Internal Medicine Physician	UO4856	FL

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821544230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAIN ANTHONY CHAMOUN D.O.

Provider Business Mailing Address
First Line	:	6 ARENA LAKE DR
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-6914
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1952 N WILLIAMSON BLVD
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5261
Country	:	US
Telephone Number	:	903-342-8251
Fax Number	:

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

Provider Enumeration Date	:	08/27/2016
Last Update Date	:	09/02/2025

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