MEDICARE: KEVIN CARL PSYCHIATRY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center	MD443748	PA

General Provider Information

NPI Number	:	1174984629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEVIN CARL PSYCHIATRY, PLLC

Provider Business Mailing Address
First Line	:	777 HINMAN AVE APT 11
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60202-2577
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 FORBES AVE STE 200
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-1735
Country	:	US
Telephone Number	:	412-278-5000
Fax Number	:	412-455-6723

Authorized Official
Title or Position	:	MD
Name	:	KEVIN CARL
Credential	:
Telephone Number	:	412-841-7398

Provider Enumeration Date	:	03/11/2016
Last Update Date	:	09/28/2020

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