| Doctor Name: | CANDACE C CHIDESTER |
| NPI Number: | 1225198724 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 12467 |
| Business Practice Address: | 1840 Locust Ave Fairmont, WV - 26554 |
| Business Phone Number: | 3043666907 |
| Business Fax Number: | 3043666216 |
| Mailing Address: | 1840 Locust Ave, FAIRMONT |
| State: | WV |
| Postal Code: | 26554 |
| Phone Number: | 3043666907 |
| Fax Number: | 3043666216 |
| NPI Enumeration Date: | 12/12/2006 |
| NPI Last Update Date: | 02/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 12467 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WV |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |