Provider Demographics
NPI:1508826421
Name:CHINGOS, JAMES CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHARLES
Last Name:CHINGOS
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 1:171 MAIN STREET
Mailing Address - Street 2:MD-VIP
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-771-0280
Mailing Address - Fax:508-771-1240
Practice Address - Street 1:171 MAIN STREET
Practice Address - Street 2:MD-VIP
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-771-0280
Practice Address - Fax:508-771-0280
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56410207R00000X
FLME98615207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110043357AMedicaid
GA313575419AMedicaid
FL2723433-00Medicaid
FL2723433-00Medicaid
FL05450ZMedicare PIN
FLP00216479Medicare PIN