Healthcare Provider Details

I. General information

NPI: 1194763201
Provider Name (Legal Business Name): NEIL DAVID CARR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 YORK ROAD SUITE 215
BALTIMORE MD
21204-7440
US

IV. Provider business mailing address

20 MARYLAND AVE
BALTIMORE MD
21208-5318
US

V. Phone/Fax

Practice location:
  • Phone: 410-486-3907
  • Fax: 410-337-8729
Mailing address:
  • Phone: 410-486-7146
  • Fax: 410-337-8729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD0015305
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: