Carlson, Waldo B
Carlson, Waldo B is an individual health care provider with primary practice located at 1707 S Stephenson Ave , Iron Mountain MI 49801-3637. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine. Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine is his primary health care specialty. Carlson, Waldo B can be contacted via phone (906) 779-7111.Contact Information
Primary practice address
1707 S Stephenson Ave
Iron Mountain MI 49801-3637
Phone: (906) 779-7111
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301043955 | Michigan |
| Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine | 2083P0011X | 4301043955 | Michigan |
| Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine | 2083P0500X | 4301043955 | Michigan |
Profile Details
| NPI number | 1356324214 |
|---|---|
| LBN Legal business name | Carlson, Waldo B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 23rd, 2005 |
| Last updated | Nov 17th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356324214 | NPPES |
| Wisconsin | MEDICAID | 30551400 | |
| Wisconsin | MEDICAID | 3228033 | |
| Wisconsin | Other | 110088084 | |
| Wisconsin | Other | 3902200121 |
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