Provider Demographics
NPI:1609397348
Name:ABOU CHAAR, WIDAD (MD)
Entity type:Individual
Prefix:DR
First Name:WIDAD
Middle Name:
Last Name:ABOU CHAAR
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 1:62 13TH ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-2056
Mailing Address - Country:US
Mailing Address - Phone:617-724-5058
Mailing Address - Fax:
Practice Address - Street 1:60 FENWOOD ROAD
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-525-7846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.0700192084N0400X
MA10193822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology