David J Chronley, M.D.

Individual provider Active NPI Pediatrics Physician · Wakefield, RI

NPI 1063597151 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1063597151
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
04859 (RI)
Practice address
4979 Tower Hill Rd
Wakefield, RI 02879-2283
Phone
(401) 789-6492
Fax
(401) 789-5524
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04859RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South County Pediatric Group, Inc. Pediatrics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 04859 RI Yes

Addresses

Primary practice location

4979 Tower Hill Rd
Wakefield, RI 02879-2283

Mailing address

4979 Tower Hill Rd
Wakefield, RI 02879-2283
Phone (401) 789-6492

Other identifiers

IdentifierTypeStateIssuer
404211OtherRITUFTS
12-00102OtherRIUNITED HEALTHCARE
1694OtherRIBLUE CROSS/BLUE SHIELD
000460OtherRIBC/BS BLUE CHIP
DC02277MedicaidRI

Other providers in Wakefield, RI

All providers in Wakefield, RI · Pediatrics Physician in Rhode Island

Sources for this page

Verify at the official NPI Registry.