Provider Demographics
NPI:1881486181
Name:CHESBROUGH, BRENT (NP)
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:CHESBROUGH
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 ELM ST
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-3906
Mailing Address - Country:US
Mailing Address - Phone:978-855-2613
Mailing Address - Fax:
Practice Address - Street 1:576 ELM ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3906
Practice Address - Country:US
Practice Address - Phone:978-855-2613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2355968207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine