Healthcare Provider Details

I. General information

NPI: 1508029463
Provider Name (Legal Business Name): ROBERT WILLIAMS CARR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 03/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CRESCENT DR NY 0300
PHILADELPHIA PA
19112-1001
US

IV. Provider business mailing address

5 CRESCENT DR NY 0300
PHILADELPHIA PA
19112-1001
US

V. Phone/Fax

Practice location:
  • Phone: 215-751-7587
  • Fax:
Mailing address:
  • Phone: 215-751-7587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD043599E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: