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Individual

DAVID WALTER CARLSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
44405 BAYVIEW AVE APT 33106, CLINTON TOWNSHIP, MI 48038-7295
(586) 212-0300

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704318026
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704318026
MI

Other

Enumeration date
10/26/2021
Last updated
05/29/2022
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