Provider Demographics
NPI:1336179878
Name:CHAG, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:CHAG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:404 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5016
Mailing Address - Country:US
Mailing Address - Phone:603-436-7344
Mailing Address - Fax:603-431-6227
Practice Address - Street 1:HARBOUR WOMEN'S HEALTH
Practice Address - Street 2:155 GRIFFIN ROAD
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4125
Practice Address - Country:US
Practice Address - Phone:603-431-6011
Practice Address - Fax:603-431-6227
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
NH6723207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
10904399OtherCAQH
NH82163118Medicaid
AC2186814OtherDEA
DX6708Medicare PIN
AC2186814OtherDEA