Provider Demographics
NPI:1871553131
Name:DALTO, CARMINE (MD)
Entity type:Individual
Prefix:DR
First Name:CARMINE
Middle Name:
Last Name:DALTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2544 COURT DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-3450
Mailing Address - Country:US
Mailing Address - Phone:980-834-5864
Mailing Address - Fax:704-864-0288
Practice Address - Street 1:2544 COURT DR
Practice Address - Street 2:SUITE D
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3450
Practice Address - Country:US
Practice Address - Phone:980-834-5864
Practice Address - Fax:704-864-0288
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24751207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6926770Medicaid
SC247511Medicaid
NC205730IMedicare PIN
SC247511Medicaid
SC247511Medicaid