Provider Demographics
NPI:1447285671
Name:CHILES, MORTON P (MD)
Entity type:Individual
Prefix:MR
First Name:MORTON
Middle Name:P
Last Name:CHILES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1200 SUNSET LN STE 2210
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3376
Mailing Address - Country:US
Mailing Address - Phone:540-825-6100
Mailing Address - Fax:540-825-1829
Practice Address - Street 1:1200 SUNSET LN STE 2210
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3376
Practice Address - Country:US
Practice Address - Phone:540-825-6100
Practice Address - Fax:540-825-1829
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027313207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB06307Medicare UPIN