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
Fax: (413) 739-1320
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598830606 NPPES
Massachusetts Other 10754 HNE
Massachusetts MEDICAID 0166014 HNE
Massachusetts Other N51761 HNE

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