| David H Chansolme Md Pc | |
|
4221 S Western Ave Suite 4010 Oklahoma City OK 73109-3447 | |
| (405) 644-6464 | |
| (405) 644-6465 |
| Full Name | David H Chansolme Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4221 S Western Ave, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | David H Chansolme (PRESIDENT) |
| Authorized Official Contact | 4056446464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David H Chansolme Md Pc Po Box 720486 Norman OK 73070-4357 Ph: (405) 644-6464 | David H Chansolme Md Pc 4221 S Western Ave Suite 4010 Oklahoma City OK 73109-3447 Ph: (405) 644-6464 |
| NPI Number | 1245440056 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 03/02/2011 |
| Medicare PECOS PAC ID | 4688644800 |
|---|---|
| Medicare Enrollment ID | O20040727000603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245440056 | NPI | - | NPPES |
| 200033350A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 23723 (Oklahoma) | Primary |
| Provider Name | David H Chansolme |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1457343402 PECOS PAC ID: 1557331782 Enrollment ID: I20040729000007 |
| Provider Name | Andrea Scott |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346406899 PECOS PAC ID: 1557530862 Enrollment ID: I20141006000272 |
| Provider Name | Miranda A Mcghee |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1538547336 PECOS PAC ID: 5799075206 Enrollment ID: I20210722000161 |
| Provider Name | Mark Patrick Verity |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811345911 PECOS PAC ID: 2264836030 Enrollment ID: I20210802003183 |
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