Carlson, Desiree A

Carlson, Desiree A is an individual health care provider with primary practice located at 680 Centre St Pathology Department, Brockton MA 02302-3395. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Carlson, Desiree A can be contacted via phone (508) 941-7414.

Contact Information

Primary practice address
680 Centre St Pathology Department Brockton MA 02302-3395
Phone: (508) 941-7414
Fax: (508) 941-6295
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 058260 Massachusetts

Profile Details

NPI number 1013944792
LBN Legal business name Carlson, Desiree A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013944792 NPPES
Massachusetts MEDICAID 3027244

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