Provider Demographics
NPI:1497745517
Name:DURAN, CARLOS I (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:I
Last Name:DURAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WASHINGTON ST
Mailing Address - Street 2:TUFTS MEDICAL CENTER
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1552
Mailing Address - Country:US
Mailing Address - Phone:617-636-5000
Mailing Address - Fax:617-636-5000
Practice Address - Street 1:800 WASHINGTON ST
Practice Address - Street 2:TUFTS MEDICAL CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1552
Practice Address - Country:US
Practice Address - Phone:617-636-5000
Practice Address - Fax:617-636-5000
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210408208000000X, 2080P0203X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA408837OtherTUFTS HEALTH PLAN
MA0190900Medicaid
MAJ24552OtherBCBS MA
H59533Medicare UPIN
MAJ24552OtherBCBS MA