Healthcare Provider Details

I. General information

NPI: 1700047115
Provider Name (Legal Business Name): CARRIE A HOUSSOCK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARRIE A STRANSKY M.D.

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 PARK CENTER CT SUITE 100
GARRISON MD
21117-5611
US

IV. Provider business mailing address

140 N MILTON AVE
BALTIMORE MD
21224-1048
US

V. Phone/Fax

Practice location:
  • Phone: 410-484-8860
  • Fax:
Mailing address:
  • Phone: 570-592-3982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD443803
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberD0082707
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: