Provider Demographics
NPI:1558346312
Name:FROSINA, CARL T (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:T
Last Name:FROSINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:70 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-9314
Mailing Address - Country:US
Mailing Address - Phone:205-814-9284
Mailing Address - Fax:205-814-9626
Practice Address - Street 1:70 PLAZA DR
Practice Address - Street 2:INRI MEDICAL ASSOCIATES PC DBA NORTHSIDE MEDICAL
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-9314
Practice Address - Country:US
Practice Address - Phone:205-814-9284
Practice Address - Fax:205-338-0865
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL15724207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051501401Medicaid
AL051501401Medicaid
AL051501401Medicare ID - Type Unspecified