Individual
CARRIE LEE CARUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1995 E STATE ST, SALEM, OH 44460-2423
(330) 332-1551
Mailing address
1995 E STATE ST, SALEM, OH 44460-2423
(330) 332-1551
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35092865
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0454744
MEDICAID GROUP #
OH
01
—
1821035940
AGMC TYPE 2 NPI #
OH
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI
OH
05
—
3029010
—
OH
01
—
3600271
MEDICARE GROUP #
OH
Enumeration date
12/14/2007
Last updated
01/15/2016
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