MEDICARE: SALVATORE DICARLO

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	2080A0000X	Pediatric Adolescent Medicine Physician	35-04-5711 - D	OH

General Provider Information

NPI Number	:	1356388508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALVATORE DICARLO

Provider Business Mailing Address
First Line	:	4310 CLIME RD
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3496
Country	:	US
Telephone Number	:	614-274-7799
Fax Number	:

Provider Business Practice Location Address
First Line	:	4310 CLIME RD
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3496
Country	:	US
Telephone Number	:	614-274-7799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	09/12/2013

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Directions to “ SALVATORE DICARLO ” Practice Location

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