Basic Information
| Provider Information | |||||||||
| NPI: | 1790780351 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHASEN | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10770 COLUMBIA PIKE STE 400 | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209014462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2404855210 | ||||||||
| FaxNumber: | 3016256906 | ||||||||
| Practice Location | |||||||||
| Address1: | 7350 VAN DUSEN RD | ||||||||
| Address2: | STE 210 | ||||||||
| City: | LAUREL | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207075268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014985500 | ||||||||
| FaxNumber: | 3014987346 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2005 | ||||||||
| LastUpdateDate: | 12/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | D0022862 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | A1110005 | 01 | DC | CAREFIRST BCBS DC | OTHER | P00679070 | 01 | MD | RAILROAD MEDICARE | OTHER | N5630028 | 01 | MD | CAREFIRST MD/DC | OTHER | 558421300 | 05 | MD | MEDICAID | 111914998 | 01 | MD | RAILROAD MEDICARE | OTHER | 411880-01 | 01 | MD | CAREFIRST BSMD | OTHER | 2516-0004 | 01 | DC | CAREFIRST BSDC | OTHER | A1130006 | 01 | DC | CAREFIRST BCBS DC | OTHER |