1942204557 NPI number — DR. CHAD JUDE ALEMAN MD

Table of content: DR. CHAD JUDE ALEMAN MD (NPI 1942204557)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942204557 NPI number — DR. CHAD JUDE ALEMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEMAN
Provider First Name:
CHAD
Provider Middle Name:
JUDE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALEMAN
Provider Other First Name:
CHAD
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1942204557
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1455 LINCOLN PKWY E
Provider Second Line Business Mailing Address:
STE 315
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30346-2209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-777-1728
Provider Business Mailing Address Fax Number:
833-471-4352

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1455 LINCOLN PKWY E
Provider Second Line Business Practice Location Address:
STE 315
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30346-2209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-777-1728
Provider Business Practice Location Address Fax Number:
833-471-4352
Provider Enumeration Date:
06/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 202K00000X , with the licence number:  056795 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 056795 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0129X , with the licence number: 056795 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2485305 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 609583907H , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com