Individual
CHARLES C PAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40 WALNUT STREET, SUITE 102, WELLESLEY, MA 02481-2102
(781) 943-3000
(781) 943-3037
Mailing address
40 WALNUT STREET, SUITE 102, WELLESLEY, MA 02481-2102
(781) 943-3000
(781) 943-3037
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA150435
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-01792
UNITED HEALTHCARE
MA
01
—
110159991
RAILROAD MEDICARE
MA
01
—
150435
TUFTS
MA
05
—
3153461
—
MA
01
—
3505250002
CIGNA
MA
01
—
65669
HARVARD PILGRIM
MD
01
—
J16706
BLUESHIELD OF MA
MA
Enumeration date
09/13/2006
Last updated
06/26/2019
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