Provider Demographics
NPI:1902806813
Name:CHUA, CHERRIE C (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERRIE
Middle Name:C
Last Name:CHUA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHERRIE
Other - Middle Name:C
Other - Last Name:CHUA-PO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:65 SPRINGFIELD RD
Mailing Address - Street 2:WESTFIELD PEDIATRICS
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-1855
Mailing Address - Country:US
Mailing Address - Phone:413-562-8330
Mailing Address - Fax:413-562-3430
Practice Address - Street 1:65 SPRINGFIELD RD
Practice Address - Street 2:WESTFIELD PEDIATRICS
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-1855
Practice Address - Country:US
Practice Address - Phone:413-562-8330
Practice Address - Fax:413-562-3430
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2157262080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000270OtherMA MEDICAID - PCC
215726OtherCONNECTICARE OF MA
043202198OtherFIRST HEALTH
043202198OtherBEACH STREET
J25781OtherHMO BLUE
MA2000270Medicaid
4278616OtherCIGNA
043202198OtherGREAT WEST HEALTH PLAN
043202198OtherHMC - PPO
MAJ25781OtherBLUE CROSS BLUE SHEILD
043202198OtherCBA
043202198OtherCONSOLIDATED HEALTH PLAN
043202198OtherHEALTH CARE VALUE MANAGEM
0000000024681OtherBOSTON MEDICAL CENTER - H
31784OtherHEALTH NEW ENGLAND
42671OtherCHILDRENS MEDICAL PLAN
043202198OtherMULTIPLAN
205892OtherHARVARD/PILGRIM
A35036Medicare ID - Type Unspecified
MA2000270Medicaid