Provider Demographics
NPI:1811971260
Name:CARLSON, ELISE M S (MD)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:M S
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:47 CLAPBOARD HILL RD
Mailing Address - Street 2:STE 2
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437
Mailing Address - Country:US
Mailing Address - Phone:203-789-2255
Mailing Address - Fax:203-495-1888
Practice Address - Street 1:326 WEST MAIN ST.
Practice Address - Street 2:UNIT 106
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460
Practice Address - Country:US
Practice Address - Phone:203-878-4312
Practice Address - Fax:203-878-4151
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2025-06-19
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Provider Licenses
StateLicense IDTaxonomies
CT040968207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001409681Medicaid
CT660000043Medicare ID - Type Unspecified
CT001409681Medicaid