Individual
DR. JOHN R CARUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17 WESTERN MARYLAND PKWY, HAGERSTOWN, MD 21740-5146
(301) 797-9240
(301) 797-4119
Mailing address
19808 BLUE HERON LN, HAGERSTOWN, MD 21742-1603
(301) 745-3948
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
18854
WV
207T00000X
Neurological Surgery Physician
Primary
D0051043
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138304300
—
MD
01
—
140005740
RR MEDICARE
—
01
—
145619
PA BLUE SHIELD PA LOC
PA
01
—
400443
PA BLUE SHIELD MD LOC
PA
01
—
68556206
MD BLUE SHIELD TRADITIONA
MD
01
—
W2660001
MD BLUE SHIELD REGIONAL
MD
Enumeration date
07/20/2006
Last updated
06/29/2017
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