MEDICARE: DR. GAVIN D CHARTIER 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	207L00000X	Anesthesiology Physician	01041179	IN
2	208VP0014X	Interventional Pain Medicine Physician	01041179	IN

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	:	1982679494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAVIN D CHARTIER M.D.

Provider Business Mailing Address
First Line	:	2020 S CLEARVIEW DR
Second Line	:
City	:	VINCENNES
State	:	IN
Zip	:	47591-5576
Country	:	US
Telephone Number	:	812-886-1151
Fax Number	:	812-886-5330

Provider Business Practice Location Address
First Line	:	1813 WILLOW ST # 3B
Second Line	:
City	:	VINCENNES
State	:	IN
Zip	:	47591-4276
Country	:	US
Telephone Number	:	812-477-7246
Fax Number	:	812-477-7240

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

Provider Enumeration Date	:	02/18/2006
Last Update Date	:	02/23/2021

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