Healthcare Provider Details

I. General information

NPI: 1942592514
Provider Name (Legal Business Name): CHAD MCDONALD D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2011
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 MAIN ST
EAST HARTFORD CT
06118
US

IV. Provider business mailing address

332 BIRNIE AVE
SPRINGFIELD MA
01107-1106
US

V. Phone/Fax

Practice location:
  • Phone: 860-569-5900
  • Fax: 860-310-2127
Mailing address:
  • Phone: 844-243-4357
  • Fax: 413-451-0037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number053445
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number53445
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1026351
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: