Provider Demographics
NPI:1902877384
Name:BARRETTE, CAROL A (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:BARRETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:123 SUMMER ST STE 320
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1216
Mailing Address - Country:US
Mailing Address - Phone:508-964-5580
Mailing Address - Fax:508-368-3143
Practice Address - Street 1:123 SUMMER ST STE 320
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-964-5580
Practice Address - Fax:508-368-3143
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034018207X00000X
MA78275207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110053513AMedicaid
MA9346906004OtherCIGNA
MABB3749934OtherDEA
MA0031560OtherNEIGHBORHOOD HEALTH PLAN
MAP3010379OtherOXFORD HEALTH
MA078275OtherTUFTS HEALTH PLAN
MAAETNAOther3200203
MA3115232Medicaid
MA78275OtherLICENSE
MAJ14270OtherBLUE SHEILD OF MA
MA103086600OtherDEPT OF LABOR
MA173841OtherHARVARD PILGRIM HEALTH
MA991076OtherFALLON HEALTH PLAN
MAP3010379OtherOXFORD HEALTH