Individual
CHARLES A TRACY
Active
Individual
CHARLES A TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
45225
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014888
NEIGHBORHOOD HEALTH
MA
01
—
045225
TUFTS
MA
05
—
3053440
—
MA
01
—
B11722
BLUE CROSS
MA
01
—
M114
HARVARD PILGRIM
MA
Enumeration date
05/19/2006
Last updated
06/27/2011
Update your record
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