Provider Demographics
NPI:1205064706
Name:CARTHON, EDWARD (IDMT)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:CARTHON
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 MONTEVUE LN
Mailing Address - Street 2:AREA B
Mailing Address - City:FORT DETRICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5058
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1270 MONTEVUE LN
Practice Address - Street 2:AREA B
Practice Address - City:FORT DETRICK
Practice Address - State:MD
Practice Address - Zip Code:21702-5058
Practice Address - Country:US
Practice Address - Phone:301-619-8603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians