Provider Demographics
NPI:1255345419
Name:WASHINGTON, CARL V (MD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:V
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2665 N DECATUR RD
Mailing Address - Street 2:SUITE 650
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6149
Mailing Address - Country:US
Mailing Address - Phone:404-508-0566
Mailing Address - Fax:404-508-0567
Practice Address - Street 1:1951 CLAIRMONT RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3415
Practice Address - Country:US
Practice Address - Phone:404-321-4600
Practice Address - Fax:404-320-0987
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-05-15
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Provider Licenses
StateLicense IDTaxonomies
GA032322207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE50348Medicare UPIN