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General NPI Number Information
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NPI Number | 1447489109
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Entity Type | Individual
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Provider Name | THOMAS EDWARD DICARLO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 12200 WARWICK BLVD STE 410
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-2548
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Country | US
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Telephone | 757-534-5454
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Fax |
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Provider Business Mailing Address
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Address Line | 856 J CLYDE MORRIS BLVD STE A
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-1318
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Country | US
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Telephone | 757-316-5800
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 2013-01830
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 241151
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 0101264413
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101264413
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD61046300
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License Number State | WA
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