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NPI Code Detail

MEDICARE: PHILLIP CARVER D.O.

MEDICARE: PHILLIP CARVER D.O.
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
12085R0202XDiagnostic Radiology PhysicianOT018684PA
2390200000XStudent in an Organized Health Care Education/Training Program
32085R0202XDiagnostic Radiology Physician0102207098VA

General Provider Information

NPI Number : 1508390097
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP CARVER D.O.
Provider Business Mailing Address
First Line : 1340 CENTRAL PARK BLVD STE 100
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-4940
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1001 SAM PERRY BLVD
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-4453
Country : US
Telephone Number : 540-741-5610
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2017
Last Update Date : 06/15/2026

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