Provider Demographics
NPI:1437457090
Name:CARBONE, JEROME EMILE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEROME
Middle Name:EMILE
Last Name:CARBONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7318 NW IOKA DR
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7359
Mailing Address - Country:US
Mailing Address - Phone:360-692-5170
Mailing Address - Fax:360-692-5170
Practice Address - Street 1:7318 NW IOKA DR
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7359
Practice Address - Country:US
Practice Address - Phone:360-692-5170
Practice Address - Fax:360-692-5170
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 00018203207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease