Provider Demographics
NPI:1407976392
Name:TRAVERSO, CARLO GIOVANNI (MB, BCHIR, PHD)
Entity Type:Individual
Prefix:DR
First Name:CARLO
Middle Name:GIOVANNI
Last Name:TRAVERSO
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Gender:M
Credentials:MB, BCHIR, PHD
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Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:THORN 14
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-5500
Mailing Address - Fax:617-525-8740
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:BLAKE 4 - ENDOSCOPY SUITE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-6113
Practice Address - Fax:617-724-6832
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2016-01-09
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Provider Licenses
StateLicense IDTaxonomies
MA238696207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine