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Contact Information

CANDACE C CHIDESTER, MD
1840 LOCUST AVE
FAIRMONT, WV26554
 Phone: 304-366-6907
 Fax: 304-366-6216
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for CANDACE C CHIDESTER · (Female)

NPI # 1225198724
Status Active
Credentials MD
Entity Individual
Enumeration date 12/12/2006
Last updated 02/23/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • WV License # 12467
  • WV Medicaid 0050726000
  • WV Other 001721214 BC
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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