Individual
DR. SHOBHA ANNETTE CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
41 MALL ROAD, LAHEY CLINIC, BURLINGTON, MA 01805-0001
(781) 744-7000
(781) 744-5378
Mailing address
41 MALL ROAD, LAHEY CLINIC, BURLINGTON, MA 01805-0001
(781) 744-7000
(781) 744-5378
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
233867
MA
208M00000X
Hospitalist Physician
Primary
233867
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110078746A
—
MA
Enumeration date
09/20/2007
Last updated
10/10/2012
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