Provider Demographics
NPI:1295581072
Name:CARMICHAEL, KAHLIL (CPT)
Entity type:Individual
Prefix:DR
First Name:KAHLIL
Middle Name:
Last Name:CARMICHAEL
Suffix:
Gender:M
Credentials:CPT
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 7145
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-7145
Mailing Address - Country:US
Mailing Address - Phone:732-921-3746
Mailing Address - Fax:
Practice Address - Street 1:315 FORSGATE DR
Practice Address - Street 2:
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1539
Practice Address - Country:US
Practice Address - Phone:732-921-3746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach