Individual
WALDO B CARLSON
Active
Individual
WALDO B CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301043955
MI
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
4301043955
MI
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
4301043955
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110088084
RR MEDICARE
MI
05
—
30551400
—
WI
05
—
3228033
—
MI
01
—
3902200121
BCBS MI
MI
Enumeration date
11/23/2005
Last updated
11/17/2022
Update your record
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