| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CHANNELLE CARR | 1760047450 | 2019-05-08 |
Channelle Carr is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1760047450. Registration indicates Channelle Carr is a provider of access to pediatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Pediatrics (Allopathic & Osteopathic Physicians, Pediatrics) (Pediatrics, ) (Primary Care/Family Planning/APRN/PA, ) (Pediatrics, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Channelle Carr MD |
| Practice Office Address | 200 N WOLFE ST BALTIMORE, MD US |
| Practice Office Telephone | 4109555710 |
| Mailing Address | 6201 GREENLEIGH AVE MIDDLE RIVER, MD 212202004 US |
| Business Telephone | 4109336423 |
| Business Fax | 4105004266 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 20 York St | New Haven, CT 065103220 | 2036884242 |
| Code | Practice | License No State |
|---|---|---|
| 208000000X PRIMARY | Access to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Pediatrics Allopathic & Osteopathic Physicians Pediatrics Pediatrics Primary Care/Family Planning/APRN/PA Pediatrics Allopathic & Osteopathic Physicians | D0094695
MD |