Provider Demographics
NPI:1609848381
Name:MOHRIN, CARL MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:MICHAEL
Last Name:MOHRIN
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 1:552 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08827-2540
Mailing Address - Country:US
Mailing Address - Phone:908-537-6861
Mailing Address - Fax:
Practice Address - Street 1:552 CHARLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08827-2540
Practice Address - Country:US
Practice Address - Phone:908-537-6861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03801000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ595716C2FOtherMEDICARE BILLING NUMBER
NJ4664400Medicaid
NJE36490Medicare UPIN