Provider Demographics
NPI:1386763381
Name:TURNER, CARL EDWARD
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:EDWARD
Last Name:TURNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 PENNSYLVANIA AVE
Mailing Address - Street 2:2A
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-4338
Mailing Address - Country:US
Mailing Address - Phone:302-428-1458
Mailing Address - Fax:302-428-1678
Practice Address - Street 1:1508 PENNSYLVANIA AVE
Practice Address - Street 2:2A
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-4338
Practice Address - Country:US
Practice Address - Phone:302-428-1458
Practice Address - Fax:302-428-1678
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10000961207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000197601Medicaid
DE083287Medicare ID - Type Unspecified
DED01094Medicare UPIN