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Individual
MICHAEL JOHN CARLSON
Active
Individual
MICHAEL JOHN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
H0079965
MD
207Q00000X
Family Medicine Physician
Primary
OT014880
PA
Other
Enumeration date
07/30/2012
Last updated
07/07/2026
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