Provider Demographics
NPI:1861483067
Name:CHAE, HEECHIN (MD)
Entity Type:Individual
Prefix:DR
First Name:HEECHIN
Middle Name:
Last Name:CHAE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:125 NASHUA ST
Practice Address - Street 2:SPAULDING REHAB HOSPITAL SRH
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1198
Practice Address - Country:US
Practice Address - Phone:617-573-2200
Practice Address - Fax:617-573-2769
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA155274208100000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ18702OtherBCBS MA
MA155274OtherTUFTS HEALTH PLAN
MA3178099Medicaid
MA3178099Medicaid
G66492Medicare UPIN