Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 45515 | MA |
N | 111NI0900X | Internist | 45515 | MA |
Y | 2084N0400X | Neurologist | 45515 | MA |
N | 2084N0600X | Clinical Neurophysiologist | 45515 | MA |
NPI | 1477537520 |
---|---|
Provider Name | David A. Chad |
First Address | Boston, MA 02114-2783 |
Second Address | Worcester, MA 01655-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 15/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0192589 | (05) | MA |
B76991 | (02) | MA |