Provider Demographics
NPI:1285615195
Name:YOUNG, CAROLYNN M (MD)
Entity type:Individual
Prefix:
First Name:CAROLYNN
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9715 MEDICAL CENTER DR
Mailing Address - Street 2:STE 330
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3320
Mailing Address - Country:US
Mailing Address - Phone:301-424-1696
Mailing Address - Fax:301-424-7135
Practice Address - Street 1:9715 MEDICAL CENTER DR
Practice Address - Street 2:STE 330
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3320
Practice Address - Country:US
Practice Address - Phone:301-424-1696
Practice Address - Fax:301-424-7135
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0061851207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD014620C21Medicare ID - Type Unspecified
MDH46147Medicare UPIN