Individual
ALVIN C CHUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18 CENTRAL STREET, BROOKFIELD, MA 01506-0699
(508) 867-9891
(508) 867-7385
Mailing address
PO BOX K299, 18 CENTRAL STREET, BROOKFIELD, MA 01506-0699
(508) 867-9891
(508) 867-7385
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
49566
MA
208VP0000X
Pain Medicine Physician
49566
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3022030
—
MA
01
—
330209666
TAX IDENTIFICATION NUMBER
MA
01
—
J06383
BLUE CROSS BLUE SHIELD OF MA
MA
Enumeration date
10/27/2005
Last updated
07/21/2008
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