Bouchereau, Chanel G
Bouchereau, Chanel G is an sole proprietor health care provider with primary practice located at 300 Stafford Street Suite 113, Springfield MA 01104-3581. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Bouchereau, Chanel G can be contacted via phone (413) 737-9746.Contact Information
Primary practice address
300 Stafford Street Suite 113
Springfield MA 01104-3581
Phone: (413) 737-9746
Fax: (413) 739-1320
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 45636 | Massachusetts |
Profile Details
| NPI number | 1598830606 |
|---|---|
| LBN Legal business name | Bouchereau, Chanel G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 22nd, 2006 |
| Last updated | Apr 12th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598830606 | NPPES |
| Massachusetts | Other | 10754 | HNE |
| Massachusetts | MEDICAID | 0166014 | HNE |
| Massachusetts | Other | N51761 | HNE |
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