Provider Demographics
NPI:1144439027
Name:CARUSO, GARSON MARK (MD, MPH)
Entity type:Individual
Prefix:
First Name:GARSON
Middle Name:MARK
Last Name:CARUSO
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 E SIDDONSBURG RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6054
Mailing Address - Country:US
Mailing Address - Phone:717-691-5409
Mailing Address - Fax:
Practice Address - Street 1:647 E SIDDONSBURG RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6054
Practice Address - Country:US
Practice Address - Phone:717-691-5409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036141E2083P0500X, 2083X0100X
MDD00571262083X0100X
FLME928592083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine