Provider Demographics
NPI:1043476575
Name:CARROLL ENDOCRINOLOGY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:CARROLL ENDOCRINOLOGY ASSOCIATES, INC.
Other - Org Name:JAMES A DICKE MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:DICKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-751-2510
Mailing Address - Street 1:826 WASHINGTON RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5779
Mailing Address - Country:US
Mailing Address - Phone:410-751-2510
Mailing Address - Fax:410-751-2515
Practice Address - Street 1:826 WASHINGTON RD
Practice Address - Street 2:SUITE 121
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5779
Practice Address - Country:US
Practice Address - Phone:410-751-2510
Practice Address - Fax:410-751-2515
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARROLL ENDOCRINOLOGY ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-04
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty