1396712311 NPI number — DR. CHARLES STEWART FUCHS MD MPH

Table of content: LEKEITH ROMEL MAPP (NPI 1386067163)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396712311 NPI number — DR. CHARLES STEWART FUCHS MD MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FUCHS
Provider First Name:
CHARLES
Provider Middle Name:
STEWART
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD MPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396712311
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
333 CEDAR ST
Provider Second Line Business Mailing Address:
WWW205
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-785-4371
Provider Business Mailing Address Fax Number:
203-785-4116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 CEDAR ST
Provider Second Line Business Practice Location Address:
YALE MEDICAL SCHOOL
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06510-3206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-785-4672
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0000X , with the licence number:  60552 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0000X , with the licence number: 56014 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X , with the licence number: 60552 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X , with the licence number: 56014 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8701139 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: J09302 . This is a "MA BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2063580 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3040001 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3070590 . This is a "MASSHEALTH MA MEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 900001124 . This is a "RR MEDICARE DFCI" identifier . This identifiers is of the category "OTHER".
  • Identifier: E34199DF . This is a "HPHC DFCI ONLY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 060552 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 45881 . This is a "FALLON COMMUNITY HEALTH" identifier . This identifiers is of the category "OTHER".