Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 35-054438 | OH |
NPI | 1134149107 |
---|---|
Provider Name | Dr. John C Carl |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 31/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000028086 | ANTHEM (01) | OH |
000000221118 | UNISON (01) | OH |
000000525885 | ANTHEM (01) | OH |
0014868160003 | PA MEDICAID (01) | PA |
0644193 | AETNA (01) | OH |
0866899 | (05) | OH |
0866899 | BCMH (01) | OH |
1134149107 | MICHIGAN MEDICAID (01) | MI |
363396 | WELLCARE (01) | OH |
727448 | BUCKEYE (01) | OH |
F02504 | (02) | OH |