Provider Demographics
NPI:1760441869
Name:GARCIA, CARLOS M (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:M
Last Name:GARCIA
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 1:3081 GREEN FOREST CT
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:AL
Mailing Address - Zip Code:36054-3927
Mailing Address - Country:US
Mailing Address - Phone:334-387-3994
Mailing Address - Fax:334-387-0955
Practice Address - Street 1:185 MITYLENE PARK LN
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7302
Practice Address - Country:US
Practice Address - Phone:334-387-9940
Practice Address - Fax:343-870-9553
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14853207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51020495GAROtherBLUE CROSS
AL000020495Medicaid
AL010057620OtherRAILROAD MEDICARE
AL51038554GAROtherBLUE CROSS
ALP00005008OtherRAILROAD MEDICARE
AL000038554Medicaid