Provider Demographics
NPI:1699060046
Name:CHAREST, TINA LEE (MD)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:LEE
Last Name:CHAREST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:200 MILL ROAD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:500 FAUNCE CORNER RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1278
Practice Address - Country:US
Practice Address - Phone:508-973-2216
Practice Address - Fax:508-973-1305
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2020-04-21
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Provider Licenses
StateLicense IDTaxonomies
MA260945207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine