Individual
DR. DESIREE A CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
680 CENTRE ST, PATHOLOGY DEPARTMENT, BROCKTON, MA 02302-3395
(508) 941-7414
(508) 941-6295
Mailing address
680 CENTRE ST, PATHOLOGY DEPARTMENT, BROCKTON, MA 02302-3395
(508) 941-7414
(508) 941-6295
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
058260
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3027244
—
MA
Enumeration date
06/27/2006
Last updated
07/08/2007
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