Doctor Name: | DR. RICHARD M. CARR |
NPI Number: | 1144223108 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 01057827A |
Business Practice Address: | 1225 E Coolspring Ave Michigan City, IN - 463606312 |
Business Phone Number: | 2198732919 |
Business Fax Number: | 2198773939 |
Mailing Address: | 1225 E Coolspring Ave, MICHIGAN CITY |
State: | IN |
Postal Code: | 463606312 |
Phone Number: | 2198732919 |
Fax Number: | 2198773939 |
NPI Enumeration Date: | 05/24/2005 |
NPI Last Update Date: | 07/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01057827A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |