1386780641 NPI number — DR. MICHELLE ELAINE TARVER-CARR M.D., PHD

Table of content: DR. MICHELLE ELAINE TARVER-CARR M.D., PHD (NPI 1386780641)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386780641 NPI number — DR. MICHELLE ELAINE TARVER-CARR M.D., PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TARVER-CARR
Provider First Name:
MICHELLE
Provider Middle Name:
ELAINE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TARVER
Provider Other First Name:
MICHELLE
Provider Other Middle Name:
ELAINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD, PHD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386780641
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/31/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10214 DOTTYS WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21044-3884
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-997-1327
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10903 NEW HAMPSHIRE AVE
Provider Second Line Business Practice Location Address:
BUILDING 66 ROOM 4202
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20903-1058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-796-6884
Provider Business Practice Location Address Fax Number:
301-847-8140
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  D0065907 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com