Provider Demographics
NPI:1871747188
Name:CONSTANT, MARIE ANDRINE CARMELLE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE ANDRINE
Middle Name:CARMELLE
Last Name:CONSTANT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:MARIE ANDRINE
Other - Middle Name:CARMELLE
Other - Last Name:CONSTANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 598
Mailing Address - Street 2:
Mailing Address - City:HARWICH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02646-0598
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:49 HARRY KEMP WAY
Practice Address - Street 2:
Practice Address - City:PROVINCETOWN
Practice Address - State:MA
Practice Address - Zip Code:02657-1618
Practice Address - Country:US
Practice Address - Phone:508-487-9395
Practice Address - Fax:508-487-6298
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA246210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110088423AMedicaid