Provider Demographics
NPI:1861451239
Name:CHIBARO, EDWARD A (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:A
Last Name:CHIBARO
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 1:44 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2752
Mailing Address - Country:US
Mailing Address - Phone:603-434-6380
Mailing Address - Fax:603-434-3626
Practice Address - Street 1:44 BIRCH ST
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2752
Practice Address - Country:US
Practice Address - Phone:603-434-6380
Practice Address - Fax:603-434-3626
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH6724208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH4146695OtherMVP HEALTHCARE
NH0104597Y0NH02OtherANTHEM BCBS
NH93989OtherAETNA
MANH0991OtherBLUE CROSS BLUE SHIELD
NH81340991Medicaid
NHB85951OtherHARVARD PILGRIM
NH006724OtherTUFTS HEALTH PLAN
NH1904021OtherUNITED HEALTHCARE
NH5150OtherHEALTHSOURCE
NH0104597Y0NH02OtherANTHEM BCBS
NH93989OtherAETNA