Provider Demographics
NPI:1235100579
Name:CONWAY, RAYMOND F (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:F
Last Name:CONWAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:30 LOCUST ST
Mailing Address - Street 2:AMBULATORY CARE PHYSICIANS AT CDH, PC
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2052
Mailing Address - Country:US
Mailing Address - Phone:413-582-2363
Mailing Address - Fax:413-582-2914
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:AMBULATORY CARE PHYSICIANS AT CDH, PC
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2363
Practice Address - Fax:413-582-2914
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2016-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA45240207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6197264Medicaid
MA632919OtherCONNECTICARE
MA045240OtherTUFTS HEALTH PLAN
MA24924OtherHEALTH NEW ENGLAND
MA438823OtherHARVARD PILGRIM HEALTH PL
MAJ09062OtherBLUE CROSS AND BLUE SHIEL
MA102532OtherCIGNA
MA2359978OtherAETNA
MA000000006702OtherBMC HEALTHNET
MA6197264Medicaid
MA24924OtherHEALTH NEW ENGLAND