Provider Demographics
NPI:1952341653
Name:FRUCI, CAROLYN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:MARIE
Last Name:FRUCI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:M
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:191 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3050
Mailing Address - Country:US
Mailing Address - Phone:508-679-4239
Mailing Address - Fax:508-679-3702
Practice Address - Street 1:191 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3050
Practice Address - Country:US
Practice Address - Phone:508-679-4239
Practice Address - Fax:508-679-3702
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26871174400000X
VA0101239948207RP1001X, 207RC0200X
MA155125207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No174400000XOther Service ProvidersSpecialist
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG70864Medicare UPIN