Individual
DR. DUSTIN M CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7641
(503) 494-8368
Mailing address
68 S SERVICE RD STE 350, MELVILLE, NY 11747-2358
(516) 945-3000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
192165
OR
207L00000X
Anesthesiology Physician
Primary
313161
NY
Other
Enumeration date
04/12/2015
Last updated
11/12/2021
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