Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 21360 | AZ |
N | 111NI0900X | Internist | 21360 | AZ |
Y | 207RA0401X | Internist - Addiction Medicine | 21360 | AZ |
NPI | 1548273055 |
---|---|
Provider Name | Dr. Michael Warren Carlton |
First Address | Chandler, AZ 85224 |
Second Address | Scottsdale, AZ 85250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 29/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
169187 | AHCCCS (01) | AZ |
F60966 | (02) | AZ |