Provider Demographics
NPI:1407959620
Name:CARP, MASON J (MD)
Entity Type:Individual
Prefix:DR
First Name:MASON
Middle Name:J
Last Name:CARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1025
Mailing Address - Country:US
Mailing Address - Phone:717-657-7025
Mailing Address - Fax:717-657-8086
Practice Address - Street 1:4212 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1025
Practice Address - Country:US
Practice Address - Phone:717-657-7025
Practice Address - Fax:717-657-8086
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023053E207VX0000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
C31008Medicare UPIN
PACA127524Medicare ID - Type Unspecified