Individual
DR. THOMAS PETER FANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 S HUNTINGTON AVE, BOSTON, MA 02130-4817
(857) 364-4418
Mailing address
150 S HUNTINGTON AVE, BOSTON, MA 02130-4817
(857) 364-4418
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
265658
MA
207Q00000X
Family Medicine Physician
MD11072
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32946-6
BCBS
RI
01
—
410381
BLUE CHIP
RI
Enumeration date
06/30/2005
Last updated
11/06/2020
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