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NPI Code Detail

MEDICARE: STEPHEN E CARLSON MD

MEDICARE:   STEPHEN E CARLSON  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
1207RG0100XGastroenterology PhysicianMD024737EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144211608
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN E CARLSON MD
Provider Business Mailing Address
First Line : 1011 REED AVE
Second Line : SUITE 300
City : WYOMISSING
State : PA
Zip : 19610-2002
Country : US
Telephone Number : 610-374-4401
Fax Number : 610-374-7140
Provider Business Practice Location Address
First Line : 1011 REED AVE
Second Line : SUITE 300
City : WYOMISSING
State : PA
Zip : 19610-2002
Country : US
Telephone Number : 610-374-4401
Fax Number : 610-374-7140
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 05/15/2014

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Directions to “ STEPHEN E CARLSON MD” Practice Location

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