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Individual

MICHAEL THOMAS CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1406 6TH AVE N, ST CLOUD HOSPITAL, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 656-7115
Mailing address
1406 6TH AVE N, ST CLOUD HOSPITAL, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 656-7115

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
107756
MN
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
14305
RI
2084P0804X
Child & Adolescent Psychiatry Physician
LP02499
RI

Other

Enumeration date
05/23/2012
Last updated
08/06/2014
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