Provider Demographics
NPI:1467671495
Name:CARR, DONNA MARIE (DC WITH PT PRIVILEGE)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:CARR
Suffix:
Gender:F
Credentials:DC WITH PT PRIVILEGE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1866
Mailing Address - Country:US
Mailing Address - Phone:301-362-1633
Mailing Address - Fax:
Practice Address - Street 1:2 N 2ND ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1866
Practice Address - Country:US
Practice Address - Phone:301-362-9252
Practice Address - Fax:301-362-1610
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01823111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD60054OtherAETNA
MDM558(DM)OtherBLUECHOICE
MDOPTIMUM CHOICEOther7019935
MDU73066Medicare UPIN
MD490243Medicare ID - Type UnspecifiedMEDICARE