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General NPI Number Information
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NPI Number | 1407243942
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Entity Type | Individual
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Provider Name | PHILIP CARULLO MD
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Gender | Male
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | CHILDRENS HEALTHCARE OF ATLANTA 1505 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30322-0010
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Country | US
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Telephone | 404-785-6670
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Fax |
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Provider Business Mailing Address
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Address Line | CHILDRENS HEALTHCARE OF ATLANTA 1505 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | D88255
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 97762
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License Number State | GA
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