MEDICARE: JOHN J CHOMYN M.D.

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	2085R0202X	Diagnostic Radiology Physician	015991	ME
2	2085R0204X	Vascular & Interventional Radiology Physician	015991	ME
3	2085R0202X	Diagnostic Radiology Physician	16461	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

General Provider Information

NPI Number	:	1982608725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN J CHOMYN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 602108
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-2108
Country	:	US
Telephone Number	:	843-792-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 HOSPITAL DR
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464
Country	:	US
Telephone Number	:	843-792-1414
Fax Number	:

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/24/2018

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Directions to “ JOHN J CHOMYN M.D.” Practice Location

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