Provider Demographics
NPI:1043286958
Name:FONTS, CARLOS A (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:A
Last Name:FONTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CAMP ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3007
Mailing Address - Country:US
Mailing Address - Phone:508-775-1984
Mailing Address - Fax:508-790-1897
Practice Address - Street 1:100 CAMP ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3007
Practice Address - Country:US
Practice Address - Phone:508-775-1984
Practice Address - Fax:508-790-1897
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73203208600000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000029644OtherBOSTO MEDICAL HEALTH PLAN
MA738720OtherTUFTS HEALTH PLAN
MA020028374OtherRAILROAD MEDICARE
MA30421OtherCHILDRENS MED SEC PLAN
MAJ09897OtherBCBS
MA3067491Medicaid
MA801558OtherHARVARD PILGIM HEALTH CAR
MAB20373801OtherCIGNA
MAJ09897OtherBCBS
E22544Medicare UPIN