Provider Demographics
NPI:1902830656
Name:LING, CARL H (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:H
Last Name:LING
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:PO BOX 2458
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-2458
Mailing Address - Country:US
Mailing Address - Phone:301-863-0004
Mailing Address - Fax:
Practice Address - Street 1:23415 THREE NOTCH RD
Practice Address - Street 2:SUITE 2052
Practice Address - City:CALIFORNIA
Practice Address - State:MD
Practice Address - Zip Code:20619-4017
Practice Address - Country:US
Practice Address - Phone:240-237-8268
Practice Address - Fax:240-237-8446
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044371207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD305201000Medicaid
MD061L186YMedicare PIN
MDC34840Medicare UPIN
P00152069Medicare PIN