Provider Demographics
NPI:1992779623
Name:THOMSON, CAREY (MD)
Entity type:Individual
Prefix:DR
First Name:CAREY
Middle Name:
Last Name:THOMSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MOUNT AUBURN ST
Mailing Address - Street 2:SUITE 419
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5600
Mailing Address - Country:US
Mailing Address - Phone:617-354-8771
Mailing Address - Fax:617-441-6393
Practice Address - Street 1:300 MOUNT AUBURN ST
Practice Address - Street 2:SUITE 419
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5600
Practice Address - Country:US
Practice Address - Phone:617-354-8771
Practice Address - Fax:617-441-6393
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA206107207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2005352Medicaid
MAA35280Medicare ID - Type Unspecified
MA2005352Medicaid