Provider Demographics
NPI:1376606731
Name:DUMONT, CHARLES ANTOINE (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:ANTOINE
Last Name:DUMONT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:30 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-0000
Mailing Address - Country:US
Mailing Address - Phone:413-582-2792
Mailing Address - Fax:413-582-4675
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2792
Practice Address - Fax:413-582-4675
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA250265207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPENDINGMedicare PIN