Provider Demographics
NPI:1245670082
Name:CARLQUIST, ERIN MARIE (MD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:CARLQUIST
Suffix:
Gender:F
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 14389
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-4389
Mailing Address - Country:US
Mailing Address - Phone:850-878-5143
Mailing Address - Fax:850-942-6622
Practice Address - Street 1:1899 EIDER CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-878-5143
Practice Address - Fax:850-942-6622
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR2300207ZP0102X
FLME135560207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology