Provider Demographics
NPI:1063423804
Name:CHIPTY, FEHMIDA A (MD)
Entity type:Individual
Prefix:
First Name:FEHMIDA
Middle Name:A
Last Name:CHIPTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 MONTVALE AVE
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3623
Mailing Address - Country:US
Mailing Address - Phone:781-828-3533
Mailing Address - Fax:781-828-2471
Practice Address - Street 1:92 HIGH ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3850
Practice Address - Country:US
Practice Address - Phone:781-391-8015
Practice Address - Fax:781-391-9119
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA154707207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA303337OtherHARVARD PILGRIM HEALTH
MA3178889Medicaid
MA154707OtherTUFTS HEALTH PLANS
MAJ17934OtherBLUE CROSS & BLUE SHIELD
MA3178889Medicaid
MA303337OtherHARVARD PILGRIM HEALTH