Provider Demographics
NPI:1336136456
Name:JONCAS, CHRISTOPHER S (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:S
Last Name:JONCAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:203 PLYMOUTH AVE STE 701
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-4300
Mailing Address - Country:US
Mailing Address - Phone:508-235-5445
Mailing Address - Fax:508-985-2001
Practice Address - Street 1:203 PLYMOUTH AVE STE 701
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-4300
Practice Address - Country:US
Practice Address - Phone:508-235-5445
Practice Address - Fax:508-985-2001
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD09625207R00000X
MA150167207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3150283Medicaid
G22622Medicare UPIN
MA3150283Medicaid
MAA21012Medicare PIN