Organization
DAVID CHADBOURNE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M CHADBOURNE MD (PRESIDENT)
(413) 746-4800
Entity
Organization
Contact information
Practice address
125 LIBERTY ST, SUITE 206, SPRINGFIELD, MA 01104
(413) 746-4800
(413) 746-4844
Mailing address
PO BOX 789, LUDLOW, MA 01056-0789
(413) 509-1000
(413) 509-1003
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M18074
BLUE CROSS GRP
MA
Enumeration date
11/21/2005
Last updated
05/01/2008
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