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General NPI Number Information
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NPI Number | 1003817560
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Entity Type | Individual
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Provider Name | GEORGE CHUDOLIJ MD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 326 NICHOLS RD SUITE 16
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City | FITCHBURG
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State | MA
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Zip | 01420-1914
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Country | US
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Telephone | 978-665-5800
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Fax | 978-665-5802
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Provider Business Mailing Address
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Address Line | PO BOX 3008
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City | LEWISTON
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State | ME
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Zip | 04243-3008
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Country | US
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Telephone | 800-720-1664
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Fax | 207-753-2020
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 47714
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 47714
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License Number State | MA
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