Healthcare Provider Details

I. General information

NPI: 1093705816
Provider Name (Legal Business Name): CARA L CHEVALIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARA LEE SMITH MD

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 WOODLAND N
LYNN MA
01904-1414
US

IV. Provider business mailing address

235 WOODLAND N
LYNN MA
01904-1414
US

V. Phone/Fax

Practice location:
  • Phone: 781-715-6608
  • Fax:
Mailing address:
  • Phone: 781-715-6608
  • Fax: 781-268-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number224119
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: