Provider Demographics
NPI:1700087806
Name:CARR, DAVID RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RAYMOND
Last Name:CARR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-1707
Mailing Address - Fax:614-293-1716
Practice Address - Street 1:540 OFFICENTER PL
Practice Address - Street 2:SUITE 240
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-5317
Practice Address - Country:US
Practice Address - Phone:614-293-1707
Practice Address - Fax:614-293-1716
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2023-09-20
Deactivation Date:
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Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.094116207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH011960Medicare PIN