Healthcare Provider Details
I. General information
NPI: 1366441602
Provider Name (Legal Business Name): CHARLES W. CAHILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/19/2005
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
57 UNION ST
WESTFIELD MA
01085-2658
US
IV. Provider business mailing address
280 CHESTNUT STREET 2ND FLOOR
SPRINGFIELD MA
01199-1001
US
V. Phone/Fax
- Phone: 413-831-7960
- Fax: 413-568-1079
- Phone: 413-794-5700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 38657 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: