Provider Demographics
NPI:1255390795
Name:CARR, JOSIAH M II (MD)
Entity type:Individual
Prefix:
First Name:JOSIAH
Middle Name:M
Last Name:CARR
Suffix:II
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 1:3500 BUSH ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7509
Mailing Address - Country:US
Mailing Address - Phone:919-875-8150
Mailing Address - Fax:919-875-9577
Practice Address - Street 1:3500 BUSH ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7509
Practice Address - Country:US
Practice Address - Phone:919-875-8150
Practice Address - Fax:919-875-9577
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35292208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8921399Medicaid
NCE86895Medicare UPIN
NC2173656Medicare PIN
NC8921399Medicaid