Provider Demographics
NPI:1881712461
Name:CARRIER, DELOS DWAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:DELOS
Middle Name:DWAYNE
Last Name:CARRIER
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 1:12696 ROCKBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-6606
Mailing Address - Country:US
Mailing Address - Phone:719-385-5965
Mailing Address - Fax:719-385-5678
Practice Address - Street 1:30 S NEVADA AVE
Practice Address - Street 2:SUITE 605
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1802
Practice Address - Country:US
Practice Address - Phone:719-385-5965
Practice Address - Fax:719-385-5678
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO402662083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine