Healthcare Provider Details

I. General information

NPI: 1831197029
Provider Name (Legal Business Name): YOUSSEF B CHEHADE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HIGHLAND ST
CLINTON MA
01510-1037
US

IV. Provider business mailing address

340 MAIN ST STE. 670
WORCESTER MA
01608-1604
US

V. Phone/Fax

Practice location:
  • Phone: 978-368-0861
  • Fax: 978-368-3939
Mailing address:
  • Phone: 508-754-3566
  • Fax: 508-438-6364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number33848
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: