Provider Demographics
NPI:1720044639
Name:SIMS, CARRIE ADELIA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:ADELIA
Last Name:SIMS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CROZER CHESTER MEDICAL CENTER - DEPT OF SURGERY, TRAUMA
Mailing Address - Street 2:ONE MEDICAL CENTER BLVD, VIV PAV, SUITE 440
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19013
Mailing Address - Country:US
Mailing Address - Phone:610-619-7444
Mailing Address - Fax:610-619-7457
Practice Address - Street 1:CROZER CHESTER MEDICAL CENTER - DEPT OF SURGERY, TRAUMA
Practice Address - Street 2:ONE MEDICAL CENTER BLVD, VIV PAV, SUITE 440
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013
Practice Address - Country:US
Practice Address - Phone:610-619-7444
Practice Address - Fax:610-619-7457
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4249072086S0102X, 2086S0127X
OH351381542086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0388938Medicaid
PAG80289Medicare UPIN