Basic Information
Provider Information
NPI: 1346291887
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAUT
FirstName: CHANDRAJIT
MiddleName: PREMANAND
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
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Mailing Information
Address1: 111 CYPRESS ST
Address2: BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION
City: BROOKLINE
State: MA
PostalCode: 024456002
CountryCode: US
TelephoneNumber: 8573070896
FaxNumber:  
Practice Location
Address1: 75 FRANCIS STREET
Address2: BRIGHAM AND WOMENS HOSPITAL
City: BOSTON
State: MA
PostalCode: 02115
CountryCode: US
TelephoneNumber: 6177328910
FaxNumber: 6175826177
Other Information
ProviderEnumerationDate: 05/12/2006
LastUpdateDate: 06/27/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X204939MAY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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