Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 211109 | MA |
N | 207L00000X | Anesthesiologist | 51692 | FL |
NPI | 1013015098 |
---|---|
Provider Name | Dr. Karen Thelma Cheshire |
First Address | Chilmark, MA 02535 |
Second Address | Chilmark, MA 02535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A62730 | (02) |