Doctor Name: | WAYNE A CARLSON |
NPI Number: | 1548202450 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 064990 |
Business Practice Address: | 2122 Grange Rd Buchanan, MI - 491079367 |
Business Phone Number: | 2694715186 |
Business Fax Number: | 2694715086 |
Mailing Address: | 2122 Grange Rd, BUCHANAN |
State: | MI |
Postal Code: | 491079367 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/12/2006 |
NPI Last Update Date: | 07/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207PE0004X |
License Number: | 064990 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Emergency Medicine |
Taxonomy Specialization: | Emergency Medical Services |
Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |