Provider Demographics
NPI:1285608398
Name:DEL RIO, CARLOS ANGEL (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ANGEL
Last Name:DEL RIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 NASHUA RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-1929
Mailing Address - Country:US
Mailing Address - Phone:978-957-9650
Mailing Address - Fax:978-957-9017
Practice Address - Street 1:505 NASHUA RD
Practice Address - Street 2:SUITE 1
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-1929
Practice Address - Country:US
Practice Address - Phone:978-957-9650
Practice Address - Fax:978-957-9017
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG11032Medicare UPIN
MAA20522Medicare ID - Type Unspecified