Provider Demographics
NPI:1922062793
Name:CARUANA, VINCENT D (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:D
Last Name:CARUANA
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:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-875-3000
Mailing Address - Fax:
Practice Address - Street 1:10 ALICE PECK DAY DR
Practice Address - Street 2:DARTMOUTH HITCHCOCK - RADIOLOGY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766
Practice Address - Country:US
Practice Address - Phone:603-650-7650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH107462085R0202X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01Y002673NH02OtherBLUE CROSS
NH010746OtherTUFTS
NH294663OtherCIGNA
NH01Y002673 NH05OtherANTHEM - MCH TAX ID
NH2450201OtherAETNA
MO200106175Medicaid
NH01Y002673NH02OtherBLUE CROSS
NHRE5977Medicare ID - Type Unspecified