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NPI Code Detail

MEDICARE: CHRISTOPHER DREW CARSWELL M.D.

MEDICARE: CHRISTOPHER DREW CARSWELL M.D.
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
1208000000XPediatrics Physician030283GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1030283OTHERGAMED BRD LICENCE

General Provider Information

NPI Number : 1790779122
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER DREW CARSWELL M.D.
Provider Business Mailing Address
First Line : 2406 BELLEVUE RD
Second Line : BLDG. 10
City : DUBLIN
State : GA
Zip : 31021-2842
Country : US
Telephone Number : 478-272-2623
Fax Number : 478-272-9984
Provider Business Practice Location Address
First Line : 2406 BELLEVUE RD
Second Line : BLDG. 10
City : DUBLIN
State : GA
Zip : 31021-2842
Country : US
Telephone Number : 478-272-2623
Fax Number : 478-272-9984
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 07/08/2007

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