Provider Demographics
NPI:1053397893
Name:JEAN, CHIT K (MD)
Entity type:Individual
Prefix:
First Name:CHIT
Middle Name:K
Last Name:JEAN
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 1:3000 GUERNSEY ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:BELLAIRE
Mailing Address - State:OH
Mailing Address - Zip Code:43906-1540
Mailing Address - Country:US
Mailing Address - Phone:740-671-6330
Mailing Address - Fax:740-671-6339
Practice Address - Street 1:3000 GUERNSEY ST
Practice Address - Street 2:SUITE 15
Practice Address - City:BELLAIRE
Practice Address - State:OH
Practice Address - Zip Code:43906-1540
Practice Address - Country:US
Practice Address - Phone:740-671-6330
Practice Address - Fax:740-671-6339
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35028866J208000000X
WV12837208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0112812000Medicaid
OH0069741Medicaid
OH0069741Medicaid
OHJE7131791Medicare ID - Type Unspecified
WV0112812000Medicaid