Provider Demographics
NPI:1366580128
Name:CARVER, BRIAN T (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:T
Last Name:CARVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4531
Mailing Address - Country:US
Mailing Address - Phone:717-737-1681
Mailing Address - Fax:717-731-1648
Practice Address - Street 1:2704 MARKET STREET
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4531
Practice Address - Country:US
Practice Address - Phone:717-737-1681
Practice Address - Fax:717-731-1648
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004479L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1704734001OtherCIGNA PROV #S
2512627OtherAETNA PROV #S CLINIC
02561600OtherBLUE CROSS PROV #S
02012401OtherBLUE CROSS PROV #S
706271OtherBLUE SHIELD PROV #
JH1018019OtherASHLINK
004479LOtherLICENSE CARVER
0990284OtherKEYSTONE PROV #
1438356001OtherCIGNA PROV #S HERD
2512613OtherAETNA
658217KPKOtherBLUE SHIELD & MEDICARE PR
CALORADOtherASHLINK
658217KPKOtherBLUE SHIELD & MEDICARE PR
2512613OtherAETNA
0990284OtherKEYSTONE PROV #
1704734001OtherCIGNA PROV #S