Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 51257 | MA |
NPI | 1043434517 |
---|---|
Provider Name | Chandra K Khasgiwala |
First Address | Chelmsford, MA 01824-4054 |
Second Address | Chelmsford, MA 01824-4054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 08/07/2007 |