Provider Demographics
NPI:1417159211
Name:VOSS, CARLYLE (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLYLE
Middle Name:
Last Name:VOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CARLYLE
Other - Middle Name:
Other - Last Name:VOSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2367 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-1965
Mailing Address - Country:US
Mailing Address - Phone:207-879-2506
Mailing Address - Fax:207-774-3439
Practice Address - Street 1:2367 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-1965
Practice Address - Country:US
Practice Address - Phone:207-879-2506
Practice Address - Fax:207-774-3439
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME66432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry