Provider Demographics
NPI:1477537058
Name:CHIRASEVEENUPRAPUND, PAT (MD)
Entity Type:Individual
Prefix:MR
First Name:PAT
Middle Name:
Last Name:CHIRASEVEENUPRAPUND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:PAT
Other - Middle Name:
Other - Last Name:CHIRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:475 FRANKLIN ST
Mailing Address - Street 2:STE 202
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702
Mailing Address - Country:US
Mailing Address - Phone:508-875-7205
Mailing Address - Fax:508-620-9214
Practice Address - Street 1:475 FRANKLIN ST
Practice Address - Street 2:STE 202
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702
Practice Address - Country:US
Practice Address - Phone:508-875-7205
Practice Address - Fax:508-620-9214
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35109207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2013797Medicaid
MA2013797Medicaid
B72583Medicare UPIN
M08331Medicare ID - Type Unspecified