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Individual

DAVID EUGENE CARLSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
277 DIVISION ST, SUITE 3, NORTH TONAWANDA, NY 14120-4667
(716) 694-3541
(716) 694-3543
Mailing address
6255 SHERIDAN DR, SUITE 304, WILLIAMSVILLE, NY 14221-4836
(716) 857-8666
(716) 630-1054

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
190642
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0661027
NY
Enumeration date
04/20/2006
Last updated
09/21/2011
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