Provider Demographics
NPI:1366441602
Name:CAHILL, CHARLES W (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:W
Last Name:CAHILL
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 1:3550 MAIN ST STE 302
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1088
Mailing Address - Country:US
Mailing Address - Phone:413-781-8290
Mailing Address - Fax:413-732-7628
Practice Address - Street 1:3550 MAIN ST STE 302
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1088
Practice Address - Country:US
Practice Address - Phone:413-781-8290
Practice Address - Fax:413-737-8540
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA38657207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA114979OtherUS HEALTHCARE
MA0010788OtherNEIGHBORHOOD HEALTH
MA10961OtherHEALTH NEW ENGLAND
MA07-04620OtherUNITED HEALTH CARE
MA038657OtherTUFTS
MA130707OtherPILGRIM
MA2067706Medicaid
MA000006339OtherBMC HEALTHNET
MA160036254OtherRAILROAD MEDICARE
MACAN51712OtherBLUE SHIELD OF MASS
MA484032OtherCONNECTICARE
MACAN51712OtherBLUE SHIELD OF MASS
MAN51712Medicare PIN