Provider Demographics
NPI:1760473110
Name:CARLOS, MICHAEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:CARLOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7350 VAN DUSEN RD
Mailing Address - Street 2:STE 130
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5267
Mailing Address - Country:US
Mailing Address - Phone:301-560-4747
Mailing Address - Fax:301-776-1725
Practice Address - Street 1:7350 VAN DUSEN RD
Practice Address - Street 2:SUITE 130
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5263
Practice Address - Country:US
Practice Address - Phone:301-560-4747
Practice Address - Fax:301-776-1725
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2017-04-04
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Provider Licenses
StateLicense IDTaxonomies
MDM59868207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG16277Medicare UPIN