Individual
CARLETTA MARY BROWN VANDERBILT
Active
Individual
CARLETTA MARY BROWN VANDERBILT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD00017168
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0167683
L&I AND CRIME VICTIMS
WA
01
—
110232336
RAILROAD MEDICARE
WA
05
—
1720047228
—
WA
05
—
1841907
—
WA
01
—
4586813
AETNA
WA
01
—
7855VA
REGENCE
WA
Enumeration date
03/22/2006
Last updated
11/19/2010
Update your record
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