Provider Demographics
NPI:1023041571
Name:CARREL, CHRISTOPHER EDSON (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:EDSON
Last Name:CARREL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3707 NEW VISION DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1702
Mailing Address - Country:US
Mailing Address - Phone:604-696-6022
Mailing Address - Fax:260-484-5919
Practice Address - Street 1:3707 NEW VISION DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1702
Practice Address - Country:US
Practice Address - Phone:604-696-6022
Practice Address - Fax:616-363-7290
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2021-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010757672085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology