Provider Demographics
NPI:1063471845
Name:SCHACHTER, AVI (MD)
Entity Type:Individual
Prefix:DR
First Name:AVI
Middle Name:
Last Name:SCHACHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-2139
Mailing Address - Country:US
Mailing Address - Phone:781-337-4105
Mailing Address - Fax:781-337-6239
Practice Address - Street 1:795 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02191-2139
Practice Address - Country:US
Practice Address - Phone:781-337-4105
Practice Address - Fax:781-337-6239
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218840207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2130483Medicaid
MA2130483Medicaid
H55018Medicare UPIN