Provider Demographics
NPI:1013015098
Name:CHESHIRE, KAREN THELMA (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:THELMA
Last Name:CHESHIRE
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 1:27 THE AERIE
Mailing Address - Street 2:
Mailing Address - City:CHILMARK
Mailing Address - State:MA
Mailing Address - Zip Code:02535
Mailing Address - Country:US
Mailing Address - Phone:508-645-5164
Mailing Address - Fax:
Practice Address - Street 1:27 THE AERIE
Practice Address - Street 2:
Practice Address - City:CHILMARK
Practice Address - State:MA
Practice Address - Zip Code:02535
Practice Address - Country:US
Practice Address - Phone:508-645-5164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA211109207L00000X
FL51692207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A62730Medicare UPIN
CH A37866Medicare ID - Type Unspecified