Basic Information
| Provider Information | |||||||||
| NPI: | 1023075868 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAUM | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3841 GREEN HILLS VILLAGE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372152691 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159362000 | ||||||||
| FaxNumber: | 6159360605 | ||||||||
| Practice Location | |||||||||
| Address1: | 3601 THE VANDERBILT CLINIC | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372325100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159363000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 03/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 03/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207WX0107X | 36131567 | IL | N | 207WX0107X | 45697 | KY | N | 207WX0107X | 72251 | MA | N | 207WX0107X | 4301102415 | MI | N | 207WX0107X | 20602 | MS | N | 207WX0107X | 46660 | AZ | N | 207WX0107X | G89425 | CA | N | 207WX0107X | 52072 | CO | N | 207WX0107X | 51992 | CT | N | 207WX0107X | ME115227 | FL | N | 207WX0107X | 69779 | GA | N | 207WX0107X | 266450 | NY | N | 207WX0107X | 25MA09294800 | NJ | N | 207WX0107X | MD448643 | PA | N | 207W00000X | 33959 | TN | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | Q003661 | 05 | TN | MEDICAID |