WALDO B CARLSON (NPI# 1356324214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356324214 |
| Entity Type | Individual |
| Full Name | WALDO B CARLSON |
| Credential | MD |
| Practice Address |
1707 S Stephenson Ave Iron Mountain MI 49801-3637 |
| Mailing Address |
Po Box 549 Iron Mountain MI 49801-0549 |
| Practice Telephone | 9067797111 |
| Mailing Telephone | 9067741313 |
| Mailing Fax Number | 9067765639 |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2019-01-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 4301043955 | MI | Allopathic & Osteopathic Physicians |
| N | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
4301043955 | MI | Allopathic & Osteopathic Physicians |
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
4301043955 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3228033 | 05 | |
| WI | 30551400 | 05 | |
| MI | RR MEDICARE | 110088084 | 01 |
| MI | BCBS MI | 3902200121 | 01 |
| Street Address |
1707 S STEPHENSON AVE |
| City | IRON MOUNTAIN |
| State | MI |
| Zip Code | 49801-3637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477096865 | Nicole Phillips | Nurse Practitioner | 1707 S Stephenson Ave, Suite 102, Iron Mountain, MI 49801-3667 | 2016-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770008062 | John M Baccino | Dietitian, Registered | 325 E H St # 133, Iron Mountain, MI 49801 | 2017-08-08 |
| 1699148692 | Bd Baker Rentals LLC | Optometrist | 2100 Aragon Street, Iron Mountain, MI 49801 | 2015-11-12 |
| 1083044762 | Integrated First Response-great Lakes | Ambulance | 719 River Avenue, Iron Mountain, MI 49801 | 2013-11-18 |
| 1912340936 | Andrew James Tomlinson | Social Worker | Iron Mountain Va, 325 East H Street, Iron Mountain, MI 49801 | 2013-04-09 |
| 1902196702 | Daniel John Fornetti | Dentist | 100 S. Stephenson Ave., Iron Mountain, MI 49801 | 2011-04-13 |
| 1871815613 | Colleen Ann Sleik | Physical Therapist | Bellin Health Physical Therapy Iron Moutain, 440 Woodward Ave, Iron Mountain, MI 49801 | 2010-02-21 |
| 1679714083 | Great Lakes Recovery Centers, Inc. | Clinic/Center | 1401 N. 26th Street, Suite 109, Escanaba, MI 49801 | 2009-03-13 |
| 1831349539 | Amanda Jane Petti | Dietitian, Registered | 300 E H Street, Nutrition & Food Service, Iron Mountain, MI 49801 | 2008-09-30 |
| 1891946521 | Riki Rouse | Hearing Instrument Specialist | W8065 S Us Hwy 2/141, Iron Mountain, MI 49801 | 2008-09-30 |
| 1366690612 | Greenlund Enterpries, Inc | Hearing Aid Equipment | W8065 S. Us High 2/141, Suite #13, Iron Mountain, MI 49801 | 2008-08-28 |
| Find all providers in zip 49801 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766639 | Corporate Occupational Health PC | Preventive Medicine | 3501 Lake Eastbrook Blvd Se Ste 144, Grand Rapids, MI 49546-5939 | 2020-10-02 |
| 1770194375 | Healthstat Inc Huhtamaki-michigan | Preventive Medicine | 5700 W Shaffer Rd, Coleman, MI 48618-9706 | 2020-08-17 |
| 1487265088 | Healthstat Inc National Gypsum-national City | Preventive Medicine | 2375 S National City Rd, National City, MI 48748-9623 | 2020-08-17 |
| 1619494762 | Healthstat Onsite Clinic Keihin Capac | Preventive Medicine | 14898 Koehn Rd, Mussey, MI 48014-4310 | 2017-08-29 |
| 1174944953 | Healthstat On-site Clinic/unified Michigan | Preventive Medicine | 520 S. Coldwater Rd., Weidman, MI 48893 | 2013-12-23 |
| 1598018152 | Healthstat- Carson City Hospital | Preventive Medicine | 46 Elm St., Carson City, MI 48811 | 2012-10-19 |
| 1609129303 | Healthstat- Jedco | Preventive Medicine | 1615 Broadway Ave Nw, Grand Rapids, MI 49504-2026 | 2012-10-18 |
| 1083905541 | Rosalind Marie Cohen | Preventive Medicine | 1106 E Cook Rd, Grand Blanc, MI 48439-8368 | 2011-05-02 |
| 1629307251 | Michigan State University | Preventive Medicine | 346 Olin Health Ctr, East Circle Drive, East Lansing, MI 48824-1037 | 2009-12-10 |
| 1649421108 | Reynolds B Brissenden IIi | Preventive Medicine | 409 Timberlake Dr W, Holland, MI 49424-5338 | 2008-10-02 |
| Find all providers with the same taxonomy | ||||
| City | IRON MOUNTAIN |
| Zip Code | 49801 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.