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General NPI Number Information
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NPI Number | 1427094234
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Entity Type | Organization
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Legal Business Name | DAVID P CHODIRKER MD
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 173 WORCESTER STREET
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City | WELLESLEY
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State | MA
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Zip | 02481-5521
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Country | US
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Telephone | 781-235-7900
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Fax | 781-237-9930
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Provider Business Mailing Address
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Address Line | 173 WORCESTER STREET
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City | WELLESLEY
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State | MA
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Zip | 02481-5521
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Country | US
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Telephone | 781-235-7900
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Fax | 781-237-9930
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Authorized Official
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Title or Position | PHYSICIAN SOLE PROPRIETOR
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Name | DAVID P CHODIRKER
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Credential | MD
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Telephone | 781-235-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 74617
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License Number State | MA
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