MR. CHANEL G BOUCHEREAU


Address: 300 Stafford Street, Suite 113, Springfield, MA 01104-3581
Phone: 4137379746

MR. CHANEL G BOUCHEREAU (NPI# 1598830606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598830606
Entity Type Individual
Full Name MR. CHANEL G BOUCHEREAU
Credential MD
Practice Address 300 Stafford Street
Suite 113
Springfield
MA 01104-3581
Practice Telephone 4137379746
Practice Fax Number 4137391320
Mailing Telephone 4137379746
Mailing Fax Number 4137391320
Enumeration Date 2006-11-22
Last Update Date 2010-04-12
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208600000X Surgery 45636 MA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MA HNE 10754 01
MA 0166014 05
MA BLUE CROSS N51761 01

Office Location

Street Address 300 STAFFORD STREET
SUITE 113
City SPRINGFIELD
State MA
Zip Code 01104-3581

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215913439 Candace G Mcdougall Nurse Practitioner 300 Stafford Street, Suites 154, 161, Springfield, MA 01104-2431 2005-12-20
1093963175 Susan Y Lattanzi Nurse Practitioner 300 Stafford Street, Suites 101, 154 & 161, Springfield, MA 01104-2431 2008-09-03
1194940593 Cameron Donaldson Internal Medicine 300 Stafford Street, #154/101, Springfield, MA 01104 2007-04-13
1659454908 Medical Diagnostics and Rehabilitation LLC Chiropractor 300 Stafford Street, Suite 360, Springfield, MA 01104 2006-10-23

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1346727567 Genoa Healthcare, LLC Durable Medical Equipment & Medical Supplies 2155 Main Street, Suite 131/133, Springfield, MA 01104 2018-07-20
1508385618 Demetrios Sotiropoulos Physician Assistant 175 Carew St Ste 250, Springfield, MA 01104 2017-09-11
1114382942 Rosana Rivera-delgado Psychologist 4017 Liberty St, Springfield, MA 01104 2015-12-21
1417363516 Springfield Family Pharmacy, Inc Pharmacy 175 Carew St, Suite 100, Springfield, MA 01104 2014-07-09
1437588837 Ariam Ivette Pena Counselor 85 St. George Road, Springfield, MA 01104 2013-11-06
1891124293 Ana E. Centeno Counselor 85 St. George Road., Springfield, MA 01104 2013-11-06
1275962003 Swany Matos Counselor 2155 Main St., Springfield, MA 01104 2013-11-02
1184053910 Claudia Eileen Quesada Counselor 2155 Main Street and St. George Road, The Gandara Center, Springfield, MA 01104 2013-11-02
1194023044 Hungry Hill Family Practice Clinic/Center 776 Liberty Street, Hungry Hill Family Practice, Springfield, MA 01104 2011-03-02
1710115308 Michael Allen Roche Counselor 332 Bernie Ave, Center for Human Development, Springfield, MA 01104 2009-06-23
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Taxonomy Information

Taxonomy Code 208600000X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery

Taxonomy Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1184114480 New Jersey Bariatric Group, PC Surgery 193 Morris Ave Fl 2, Springfield, NJ 07081-1211 2018-05-14
1174903488 Samuel J Rheinhardt Surgery 701 N 1st St Ste D327, Springfield, IL 62702-3757 2015-06-02
1588099725 Francis Milton Corry Surgery 2859 E. Utica, Springfield, MO 65804 2013-09-06
1881033926 Frank A. Cornella Dds, Md PC Surgery 3237 E Sunshine St Ste B, Springfield, MO 65804-6919 2013-06-21
1881943678 Roland Folse Surgery 2 Virginia Lane, Springfield, IL 62712 2012-09-07
1780939462 Daniel Caleb Persinger Surgery 100 W Mccreight Ave Ste 110, Springfield, OH 45504-1890 2012-07-18
1154618775 Alexandria Dailey Mcdow Surgery 701 N 1st St Ste D308, Springfield, IL 62702-3757 2011-07-04
1356655054 Allison Melissa Key Surgery 1965 S Fremont Ave Ste 230, Springfield, MO 65804-2258 2010-08-05
1679704761 James P Buwen Surgery 193 Morris Ave, 2nd Floor, New Jersey Bariatric Center, Springfield, NJ 07081 2009-08-06
1386871069 Lindsey Leigh Saint Surgery 315 W Carpenter St Fl 2, Springfield, IL 62702 2009-06-19
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Competitor

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City SPRINGFIELD
Zip Code 01104

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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