Provider Demographics
NPI:1306014790
Name:ANDERSON, CHAD LAUREL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:LAUREL
Last Name:ANDERSON
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 1:27 ALAN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-2401
Mailing Address - Country:US
Mailing Address - Phone:617-692-0874
Mailing Address - Fax:
Practice Address - Street 1:27 ALAN RD
Practice Address - Street 2:
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-2401
Practice Address - Country:US
Practice Address - Phone:617-692-0874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA237194207L00000X
MEEL111037207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology