Provider Demographics
NPI:1316048739
Name:CHATFIELD, MARCIA C (D O)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:C
Last Name:CHATFIELD
Suffix:
Gender:F
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PRIMROSE ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-2659
Mailing Address - Country:US
Mailing Address - Phone:978-469-7100
Mailing Address - Fax:978-469-7199
Practice Address - Street 1:1 PARKWAY
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6278
Practice Address - Country:US
Practice Address - Phone:978-521-3250
Practice Address - Fax:978-469-5311
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL650594183207R00000X
MA232141207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650594183OtherTAX ID
40357Medicare ID - Type Unspecified