Provider Demographics
NPI:1043234321
Name:CHUTTANI, KABIR (MD)
Entity Type:Individual
Prefix:
First Name:KABIR
Middle Name:
Last Name:CHUTTANI
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 1:8 NAMELOC RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-1418
Mailing Address - Country:US
Mailing Address - Phone:617-906-5316
Mailing Address - Fax:508-880-0077
Practice Address - Street 1:72 WASHINGTON ST
Practice Address - Street 2:SUITE 1400-1700
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2491
Practice Address - Country:US
Practice Address - Phone:508-880-0077
Practice Address - Fax:508-880-5247
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA70440207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA300041OtherHPHC
MA0538177OtherAETNA
MA3097196Medicaid
MAJ12874OtherBCBS
MA000000026423OtherBMC HEALTHNET
MA070440OtherTUFTS
MA0538177OtherAETNA
MAJ12874Medicare ID - Type Unspecified