Provider Demographics
NPI:1891486700
Name:CARR, CHARLES M (CDCA)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:M
Last Name:CARR
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11012 LINNET AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-4865
Mailing Address - Country:US
Mailing Address - Phone:216-386-0648
Mailing Address - Fax:
Practice Address - Street 1:11012 LINNET AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-4865
Practice Address - Country:US
Practice Address - Phone:216-386-0648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist