Provider Demographics
NPI:1366916512
Name:CHATMAN, MEASHAWN JR
Entity type:Individual
Prefix:MR
First Name:MEASHAWN
Middle Name:
Last Name:CHATMAN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 E WILSON BRIDGE RD STE 109
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2324
Mailing Address - Country:US
Mailing Address - Phone:614-772-1170
Mailing Address - Fax:
Practice Address - Street 1:77 E WILSON BRIDGE RD STE 109
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2324
Practice Address - Country:US
Practice Address - Phone:614-772-1170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty