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General NPI Number Information
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NPI Number | 1629334784
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Entity Type | Individual
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Provider Name | MICHAEL ELLIOT CARLTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 85 SEYMOUR ST STE 200
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City | HARTFORD
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State | CT
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Zip | 06106-5509
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Country | US
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Telephone | 860-246-6589
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Fax |
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Provider Business Mailing Address
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Address Line | 101 N PLAINS INDUSTRIAL RD
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City | WALLINGFORD
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State | CT
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Zip | 06492-2360
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Country | US
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Telephone | 860-289-3375
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 269606
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 053434
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License Number State | CT
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