Healthcare Provider Details

I. General information

NPI: 1942293261
Provider Name (Legal Business Name): SUSAN MARIE CHABOT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 WASHINGTON STREET SUITE 240
NORWOOD MA
02062-3441
US

IV. Provider business mailing address

62 BROWN ST SUITE 507
HAVERHILL MA
01830-6778
US

V. Phone/Fax

Practice location:
  • Phone: 781-769-4660
  • Fax: 781-769-0371
Mailing address:
  • Phone: 781-769-4660
  • Fax: 781-769-0371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number58767
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number58767
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: