Basic Information
| Provider Information | |||||||||
| NPI: | 1396712311 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FUCHS | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | STEWART | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 CEDAR ST | ||||||||
| Address2: | WWW205 | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037854371 | ||||||||
| FaxNumber: | 2037854116 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 CEDAR ST | ||||||||
| Address2: | YALE MEDICAL SCHOOL | ||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065103206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037854672 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2006 | ||||||||
| LastUpdateDate: | 02/10/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0000X | 60552 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RH0000X | 56014 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RX0202X | 60552 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RX0202X | 56014 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 8701139 | 01 | CIGNA | OTHER | J09302 | 01 | MA BCBS | OTHER | 2063580 | 01 | AETNA US HEALTHCARE | OTHER | 3040001 | 01 | UNITED HEALTH CARE | OTHER | 3070590 | 01 | MASSHEALTH MA MEDICAID | OTHER | 900001124 | 01 | RR MEDICARE DFCI | OTHER | E34199DF | 01 | HPHC DFCI ONLY | OTHER | 060552 | 01 | TUFTS | OTHER | 45881 | 01 | FALLON COMMUNITY HEALTH | OTHER |