| Chestnut Family Practice, Pllc | |
|
1013 Chestnut Ln Suite 110 Matthews NC 28104-8566 | |
| (704) 268-9267 | |
| Not Available |
| Full Name | Chestnut Family Practice, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1013 Chestnut Ln, Matthews, North Carolina |
| Authorized Official Name and Position | Susan Elise Ladd-snively (OWNER) |
| Authorized Official Contact | 7042689267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chestnut Family Practice, Pllc 1013 Chestnut Ln Suite 110 Matthews NC 28104-8566 Ph: (704) 268-9267 | Chestnut Family Practice, Pllc 1013 Chestnut Ln Suite 110 Matthews NC 28104-8566 Ph: (704) 268-9267 |
| NPI Number | 1134654338 |
|---|---|
| Provider Enumeration Date | 04/25/2017 |
| Last Update Date | 05/01/2017 |
| Medicare PECOS PAC ID | 8820367410 |
|---|---|
| Medicare Enrollment ID | O20170713002403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134654338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 220342 (North Carolina) | Primary |
| Provider Name | Susan Elise Ladd-snively |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437175791 PECOS PAC ID: 8426007006 Enrollment ID: I20100608000127 |
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