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NPI Code Detail

MEDICARE: JAMES HERBERT CHESEBRO M.D.

MEDICARE: JAMES HERBERT CHESEBRO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician76412MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275520439
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES HERBERT CHESEBRO M.D.
Provider Business Mailing Address
First Line : PO BOX 415348
Second Line :
City : BOSTON
State : MA
Zip : 02241-5348
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 119 BELMONT ST
Second Line :
City : WORCESTER
State : MA
Zip : 01605-2903
Country : US
Telephone Number : 508-793-6381
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2005
Last Update Date : 11/03/2010

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