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Individual

CARL LEON DANIELSON III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD FACS

Contact information

Practice address
50 ROWE STREET, SUITE 400, MELROSE, MA 02176
(781) 665-4462
(781) 620-1930
Mailing address
50 ROWE STREET, SUITE 400, MELROSE, MA 02176
(781) 665-4462
(781) 620-1930

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
76101
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0035205
NEIGHBORHOOD HEALTH PLAN
01
076101
MEDICARE PREFERRED TUFTS
01
3093719
MASSHEALTH
05
3093719
MA
01
39271
COST CARE
01
459233
AETNA
01
8557
HARVARD PILGRIM
01
99028701
NETWORK HEALTH
01
J12576
BLUE CROSS BLUE SHIELD
01
PR12357520001
CIGNA
Enumeration date
06/22/2006
Last updated
03/13/2015
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