Individual
DR. CHARLES T PU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 CHARLES RIVER PLAZA, SUITE 501 CPZ 502, BOSTON, MA 02114-2723
(617) 726-2066
(617) 228-6306
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-2066
(617) 228-6306
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
73771
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
73771
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
073771
TUFTS HEALTH PLAN
MA
05
—
3099466
—
MA
01
—
J11653
BCBS MA
MA
Enumeration date
10/28/2005
Last updated
07/19/2012
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