MEDICARE: DR. DONALD COLANTINO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	26717	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	026717	OTHER	MA	TUFTS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225008410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD COLANTINO MD

Provider Business Mailing Address
First Line	:	92 MONTVALE AVE
Second Line	:	2002
City	:	STONEHAM
State	:	MA
Zip	:	02180-3647
Country	:	US
Telephone Number	:	781-279-2030
Fax Number	:	781-279-2086

Provider Business Practice Location Address
First Line	:	92 MONTVALE AVE
Second Line	:	2002
City	:	STONEHAM
State	:	MA
Zip	:	02180-3647
Country	:	US
Telephone Number	:	781-279-2030
Fax Number	:	781-279-2086

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	07/08/2007

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