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Contact Information

FARES G MOUCHANTAF, MD
77 HERRICK ST
LAHEY PULMONARY, BEVERLY
BEVERLY, MA01915
 Phone: 978-998-4601
 Fax: 978-998-4973
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for FARES G MOUCHANTAF · (Male)

NPI # 1255476198
Status Active
Credentials MD
Entity Individual
Enumeration date 02/20/2007
Last updated 03/19/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 225515
  • MA Medicaid 110075967A
Hospital affiliation(s)
  • BEVERLY HOSPITAL CORPORATION - (Acute Care)
    85 HERRICK STREET
    BEVERLY, MA 01915
  • LAHEY CLINIC HOSPITAL - (Acute Care)
    41 & 45 MALL ROAD
    BURLINGTON, MA 01803
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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