Provider Demographics
NPI:1932109055
Name:BEAUCHER, WILFRED N (MD)
Entity Type:Individual
Prefix:DR
First Name:WILFRED
Middle Name:N
Last Name:BEAUCHER
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 1:9 VILLAGE SQ
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2712
Mailing Address - Country:US
Mailing Address - Phone:978-256-4531
Mailing Address - Fax:978-256-1377
Practice Address - Street 1:9 VILLAGE SQ
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2712
Practice Address - Country:US
Practice Address - Phone:978-256-4531
Practice Address - Fax:978-256-1377
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA40850207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB13045Medicare ID - Type UnspecifiedMASS MEDICARE NUMBER
NHRE1203Medicare ID - Type UnspecifiedNH MEDICARE NUMBER
A34175Medicare UPIN