Provider Demographics
NPI:1063778363
Name:SCHRAGE, CARLY JIGANTI (MD)
Entity type:Individual
Prefix:DR
First Name:CARLY
Middle Name:JIGANTI
Last Name:SCHRAGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CARLY
Other - Middle Name:JIGANTI
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:85 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-3113
Mailing Address - Country:US
Mailing Address - Phone:603-524-7402
Mailing Address - Fax:603-227-7596
Practice Address - Street 1:85 SPRING ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3113
Practice Address - Country:US
Practice Address - Phone:603-524-7402
Practice Address - Fax:603-227-7596
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA149372207YX0007X
NH22377207YX0007X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck