Healthcare Provider Details
I. General information
NPI: 1609850544
Provider Name (Legal Business Name): CARO FAMILY PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
206 MONTAGUE AVE
CARO MI
48723-1918
US
IV. Provider business mailing address
206 MONTAGUE AVE
CARO MI
48723-1918
US
V. Phone/Fax
- Phone: 989-673-2102
- Fax: 989-673-1591
- Phone: 989-673-2102
- Fax: 989-673-1591
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
AFONSO
FERREIRA
Title or Position: PRESIDENT
Credential: MD
Phone: 989-673-2102