MEDICARE: JAMES E. CARRABRE MD

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	207P00000X	Emergency Medicine Physician	36993	MN
2	207Q00000X	Family Medicine Physician	36993	MN
3	207QS0010X	Sports Medicine (Family Medicine) Physician	36993	MN

General Provider Information

NPI Number	:	1932148046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES E. CARRABRE MD

Provider Business Mailing Address
First Line	:	9100 HUBER AVE SW
Second Line	:
City	:	HOWARD LAKE
State	:	MN
Zip	:	55349-4406
Country	:	US
Telephone Number	:	952-292-4707
Fax Number	:	952-955-3115

Provider Business Practice Location Address
First Line	:	9100 HUBER AVE SW
Second Line	:
City	:	HOWARD LAKE
State	:	MN
Zip	:	55349-4406
Country	:	US
Telephone Number	:	952-292-4707
Fax Number	:	952-955-3115

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	07/25/2012

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