Individual
CARLO J DEAUGUSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 782-5908
(717) 782-5716
Mailing address
307 S FRONT ST, 1ST FLOOR, HARRISBURG, PA 17104-1621
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS004246L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000805010
—
PA
Enumeration date
05/15/2006
Last updated
07/07/2015
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