Provider Demographics
NPI:1477624682
Name:LAWSON, CARLA MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:MICHELLE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4339
Mailing Address - Country:US
Mailing Address - Phone:410-879-9100
Mailing Address - Fax:410-879-0227
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 206
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:410-879-9100
Practice Address - Fax:410-879-0227
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061509207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2223790OtherFIRST HEALTH
MD126722OtherEHP
MD7204542OtherAETNA PPO
MD406130600Medicaid
MD64263101OtherCAREFIRST
MD243567OtherKAISER
MDP00157973OtherRAILROAD MEDICARE
MD3127610OtherMAMSI
MD3535408OtherAETNA HMO
MD5537OtherHELIX
DCE5130011OtherCAREFIRST BLUECHOICE
MD64263101OtherCAREFIRST
MD519LJ037Medicare ID - Type Unspecified