Provider Demographics
NPI:1881676989
Name:TALMO, CARL T (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:T
Last Name:TALMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:125 PARKER HILL AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02120
Mailing Address - Country:US
Mailing Address - Phone:617-754-5474
Mailing Address - Fax:617-754-5473
Practice Address - Street 1:125 PARKER HILL AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02120
Practice Address - Country:US
Practice Address - Phone:617-754-5474
Practice Address - Fax:617-754-5473
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223883207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2107376Medicaid
MAAA67640OtherHARVARD PILGRIM
MA5695293OtherAETNA
MAJ28844OtherBCBS MA
MA462229OtherTUFTS HEALTH PLAN
MA2107376Medicaid