Provider Demographics
NPI:1992788202
Name:CARLIN, MARIE CLAIRE (MD)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:CLAIRE
Last Name:CARLIN
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 1:501 OFFICE CENTER DR
Mailing Address - Street 2:SUITE 195
Mailing Address - City:FT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-3220
Mailing Address - Country:US
Mailing Address - Phone:215-836-7900
Mailing Address - Fax:215-836-0119
Practice Address - Street 1:501 OFFICE CENTER DR
Practice Address - Street 2:SUITE 195
Practice Address - City:FT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3220
Practice Address - Country:US
Practice Address - Phone:215-836-7900
Practice Address - Fax:215-836-0119
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037823E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA148364KS5Medicare ID - Type Unspecified
PAC31885Medicare UPIN