National Provider Identifier
Charles Gustav Carlson, MD
Charles Gustav Carlson, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Rochester, NY and a listed phone number of (716) 517-0717.
Profile Overview
- NPI
- 1588450936
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- April 15, 2025
- Last Updated
- April 15, 2025
Practice Location
- 601 Elmwood Ave
- Rochester, NY 14642-0002
Phone: (716) 517-0717
Mailing Address
- 66 Birdsong Pkwy
- Orchard Park, NY 14127-3068
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1588450936
- Entity Type
- Individual
- Last Name
- Carlson
- First Name
- Charles
- Middle Name
- Gustav
- Credential
- MD
- Mailing Street Address
- 66 Birdsong Pkwy
- Mailing City
- Orchard Park
- Mailing State
- NY
- Mailing ZIP Code
- 14127-3068
- Mailing Country
- US
- Mailing Phone
- (716) 517-0717
- Practice Street Address
- 601 Elmwood Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14642-0002
- Practice Country
- US
- Practice Phone
- (716) 517-0717
- Enumeration Date
- April 15, 2025
- Last Updated
- April 15, 2025
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- April 15, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)