Provider Demographics
NPI:1376594606
Name:CARSTENS, MICHAEL DAVID (OD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:CARSTENS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 S ELLIOTT RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5831
Mailing Address - Country:US
Mailing Address - Phone:919-968-4774
Mailing Address - Fax:919-942-5291
Practice Address - Street 1:235 S ELLIOTT RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5831
Practice Address - Country:US
Practice Address - Phone:919-968-4774
Practice Address - Fax:919-942-5291
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1945152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC093TPOtherBCBS OF NC
V04481Medicare UPIN
NC093TPOtherBCBS OF NC