Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 210408 | MA |
Y | 2080P0203X | Pediatric Critical Care Doctor | 210408 | MA |
N | 2080P0214X | Pediatric Pulmonologist | 210408 | MA |
NPI | 1497745517 |
---|---|
Provider Name | Dr. Carlos I Duran |
First Address | Boston, MA 02111-1552 |
Second Address | Boston, MA 02111-1552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 08/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0190900 | (05) | MA |
408837 | TUFTS HEALTH PLAN (01) | MA |
H59533 | (02) | |
J24552 | BCBS MA (01) | MA |