Provider Demographics
NPI:1770582603
Name:CARLAN, PAUL DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAVID
Last Name:CARLAN
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 1:329 CONWAY ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1521
Mailing Address - Country:US
Mailing Address - Phone:413-774-6301
Mailing Address - Fax:866-644-0871
Practice Address - Street 1:329 CONWAY ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1521
Practice Address - Country:US
Practice Address - Phone:413-774-6301
Practice Address - Fax:866-644-0871
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221540208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1979896001OtherCIGNA HEALTH PLANS
MA467560OtherTUFTS HEALTH PLAN
MA99439OtherFALLON COMMUNITY HEALTH PLAN
MA2082934Medicaid
MA221540OtherCONNECTICARE
MAAA19115OtherHARVARD PILGRIM HEALTHCARE
MA3640514OtherAETNA/US HEALTHCARE
MA34981OtherHEALTH NEW ENGLAND
MAJ28015OtherBLUE CROSS & BLUE SHIELD
MA000000028884OtherBOSTON MEDICAL CENTER HEALTHNET PLAN
MA3640514OtherAETNA/US HEALTHCARE
MAI14546Medicare UPIN
MAJ28015OtherBLUE CROSS & BLUE SHIELD