=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891903712
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MUSHTAQUE A CHACHAR MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2007
-----------------------------------------------------
Last Update Date | 11/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 PAGE ST
-----------------------------------------------------
City | NEW BEDFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02740-3464
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-973-9180
-----------------------------------------------------
Fax | 508-973-9185
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 MILL ROAD SUITE 180
-----------------------------------------------------
City | FAIRHAVEN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02719-5252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-973-2000
-----------------------------------------------------
Fax | 508-985-2001
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RS0012X
-----------------------------------------------------
Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 231466
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 231466
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------