Provider Demographics
NPI:1851626493
Name:CARIGNAN, CHARLES STANWOOD (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:STANWOOD
Last Name:CARIGNAN
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 1:18 YARMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5810
Mailing Address - Country:US
Mailing Address - Phone:978-460-0773
Mailing Address - Fax:
Practice Address - Street 1:18 YARMOUTH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5810
Practice Address - Country:US
Practice Address - Phone:978-460-0773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053947208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice