Provider Demographics
NPI:1871519066
Name:CHESSON, ANDREW (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:CHESSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 890273
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-0273
Mailing Address - Country:US
Mailing Address - Phone:828-428-2446
Mailing Address - Fax:828-428-8226
Practice Address - Street 1:137 ISLAND FORD RD
Practice Address - Street 2:
Practice Address - City:MAIDEN
Practice Address - State:NC
Practice Address - Zip Code:28650-8735
Practice Address - Country:US
Practice Address - Phone:828-428-2446
Practice Address - Fax:828-428-8226
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300322207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891331EMedicaid
NC1311EOtherBCBS - MAIDEN
NC1311EOtherBCBS - MAIDEN
NCH56895Medicare UPIN
NC2014476AMedicare ID - Type UnspecifiedMEDICARE NC