Provider Demographics
NPI:1154554392
Name:TEHAN, CHELSEA BOSTON (MD)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:BOSTON
Last Name:TEHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 TECHNOLOGY PKWY NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1369
Mailing Address - Country:US
Mailing Address - Phone:762-235-1038
Mailing Address - Fax:
Practice Address - Street 1:115 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ADAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30103-2467
Practice Address - Country:US
Practice Address - Phone:470-601-5750
Practice Address - Fax:770-877-3655
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA74113208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics