Chidester, Candace C
Chidester, Candace C is an sole proprietor health care provider with primary practice located at 1840 Locust Ave , Fairmont WV 26554. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Chidester, Candace C can be contacted via phone (304) 366-6907.Contact Information
Primary practice address
1840 Locust Ave
Fairmont WV 26554
Phone: (304) 366-6907
Fax: (304) 366-6216
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 12467 | West Virginia |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 12467 | West Virginia |
Profile Details
| NPI number | 1225198724 |
|---|---|
| LBN Legal business name | Chidester, Candace C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 12th, 2006 |
| Last updated | Feb 23rd, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225198724 | NPPES |
| West Virginia | MEDICAID | 0050726000 | |
| West Virginia | Other | 001721214 |
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