Provider Demographics
NPI:1467515163
Name:DUMONT, TARA J (MD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:J
Last Name:DUMONT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:280 CHESTNUT ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:325B KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2370
Practice Address - Country:US
Practice Address - Phone:413-387-4100
Practice Address - Fax:413-387-4119
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA239760207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110083616AMedicaid
MA110083616AMedicaid