Provider Demographics
NPI:1700080538
Name:CARLIN, EDUARDO JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:JAVIER
Last Name:CARLIN
Suffix:
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 1:1215 PLEASANT ST STE 600
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1409
Mailing Address - Country:US
Mailing Address - Phone:515-241-6542
Mailing Address - Fax:515-241-8789
Practice Address - Street 1:1215 PLEASANT ST
Practice Address - Street 2:SUITE 204
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1416
Practice Address - Country:US
Practice Address - Phone:515-241-6542
Practice Address - Fax:515-241-8789
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-389302080P0206X
WI829442080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1700080538Medicaid
NE100265165-00Medicaid
NE100265165-00Medicaid