Provider Demographics
NPI:1225007305
Name:PATTON, CARLA S (MD)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:S
Last Name:PATTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 829641
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19182
Mailing Address - Country:US
Mailing Address - Phone:672-370-5296
Mailing Address - Fax:215-230-3725
Practice Address - Street 1:1456 FERRY RD
Practice Address - Street 2:STE 600
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2391
Practice Address - Country:US
Practice Address - Phone:215-230-8390
Practice Address - Fax:215-230-8392
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD030454E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01786222Medicaid
C31408Medicare UPIN
PA01786222Medicaid