Provider Demographics
NPI:1972575496
Name:CARSON, DONALD G (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:G
Last Name:CARSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4131 BRECKENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PRESTO
Mailing Address - State:PA
Mailing Address - Zip Code:15142-1123
Mailing Address - Country:US
Mailing Address - Phone:412-276-0599
Mailing Address - Fax:
Practice Address - Street 1:3380 BOULEVARD OF THE ALLIES
Practice Address - Street 2:SUITE 1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3125
Practice Address - Country:US
Practice Address - Phone:412-621-7575
Practice Address - Fax:412-621-6353
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD020965E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA153403Medicare ID - Type Unspecified
PAE63960Medicare UPIN