1043476575 NPI number — CARROLL ENDOCRINOLOGY ASSOCIATES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043476575 NPI number — CARROLL ENDOCRINOLOGY ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARROLL ENDOCRINOLOGY ASSOCIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JAMES A DICKE MD PA
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043476575
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
826 WASHINGTON RD
Provider Second Line Business Mailing Address:
SUITE 121
Provider Business Mailing Address City Name:
WESTMINSTER
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21157-5779
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-751-2510
Provider Business Mailing Address Fax Number:
410-751-2515

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
826 WASHINGTON RD
Provider Second Line Business Practice Location Address:
SUITE 121
Provider Business Practice Location Address City Name:
WESTMINSTER
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21157-5779
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-751-2510
Provider Business Practice Location Address Fax Number:
410-751-2515
Provider Enumeration Date:
08/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DICKE
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
ALLEN
Authorized Official Title or Position:
M.D.
Authorized Official Telephone Number:
410-751-2510

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com