Provider Demographics
NPI:1790779122
Name:CARSWELL, CHRISTOPHER DREW (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DREW
Last Name:CARSWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 BELLEVUE RD
Mailing Address - Street 2:BLDG. 10
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-2842
Mailing Address - Country:US
Mailing Address - Phone:478-272-2623
Mailing Address - Fax:478-272-9984
Practice Address - Street 1:2406 BELLEVUE RD
Practice Address - Street 2:BLDG. 10
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2842
Practice Address - Country:US
Practice Address - Phone:478-272-2623
Practice Address - Fax:478-272-9984
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA030283208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA030283OtherMED BRD LICENCE