Provider Demographics
NPI:1699078642
Name:HIGLEY CARBONE, MARY MARGARET (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:HIGLEY CARBONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7318 NW IOKA DR
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7359
Mailing Address - Country:US
Mailing Address - Phone:360-271-9658
Mailing Address - Fax:
Practice Address - Street 1:7318 NW IOKA DR
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7359
Practice Address - Country:US
Practice Address - Phone:360-271-9658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 00015744207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism