Provider Demographics
NPI:1194763201
Name:CARR, NEIL DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:DAVID
Last Name:CARR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5318
Mailing Address - Country:US
Mailing Address - Phone:410-486-7146
Mailing Address - Fax:410-337-8729
Practice Address - Street 1:7801 YORK ROAD
Practice Address - Street 2:SUITE 215
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-7440
Practice Address - Country:US
Practice Address - Phone:410-486-3907
Practice Address - Fax:410-337-8729
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00153052084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD154101300Medicaid
MD154101300Medicaid