| Doctor Name: | DR. JOHN H CHIDESTER |
| NPI Number: | 1124013586 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD-019797-E |
| Business Practice Address: | 254 W. Lancaster Ave Suite 2 Malvern, PA - 193553087 |
| Business Phone Number: | 6106445040 |
| Business Fax Number: | 6106409170 |
| Mailing Address: | 254 W. Lancaster Ave, Suite 2 MALVERN |
| State: | PA |
| Postal Code: | 193553087 |
| Phone Number: | 6106445040 |
| Fax Number: | 6106409170 |
| NPI Enumeration Date: | 09/13/2005 |
| NPI Last Update Date: | 03/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | MD-019797-E |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |