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Individual

DR. CAROL A DIVAIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
55 FRUIT ST YAW 3056, PODIATRY GROUP, BOSTON, MA 02114-2696
(617) 726-3487
(617) 726-2739
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 726-3487
(617) 724-3384

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1888
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0362735
MA
01
718636
TUFTS HEALTH PLAN
MA
01
Y70893
BCBS MA
MA
Enumeration date
10/26/2005
Last updated
08/01/2012
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