Provider Demographics
NPI:1891903712
Name:CHACHAR, MUSHTAQUE A (MD)
Entity type:Individual
Prefix:
First Name:MUSHTAQUE
Middle Name:A
Last Name:CHACHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:200 MILL ROAD SUITE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-985-2001
Practice Address - Street 1:101 PAGE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3464
Practice Address - Country:US
Practice Address - Phone:508-973-9180
Practice Address - Fax:508-973-9185
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2024-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA231466207RS0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND10671OtherLICENSE - ND
NDP00624517OtherRR MEDICARE
NDN713709Medicare PIN