Provider Demographics
NPI:1043434517
Name:KHASGIWALA, CHANDRA K (MD)
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:K
Last Name:KHASGIWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 TURNPIKE RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-4054
Mailing Address - Country:US
Mailing Address - Phone:978-328-1016
Mailing Address - Fax:
Practice Address - Street 1:160 TURNPIKE RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-4054
Practice Address - Country:US
Practice Address - Phone:978-328-1016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51257207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology