Healthcare Provider Details

I. General information

NPI: 1659326395
Provider Name (Legal Business Name): CARO HEALTH PLAZA PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 W CARO RD
CARO MI
48723-9260
US

IV. Provider business mailing address

1525 W CARO ROAD
CARO MI
48723-9260
US

V. Phone/Fax

Practice location:
  • Phone: 989-672-2100
  • Fax:
Mailing address:
  • Phone: 989-791-2455
  • Fax: 989-672-0748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301059644
License Number StateMI

VIII. Authorized Official

Name: NAVEED MAHFOOZ
Title or Position: OWNER
Credential: MD
Phone: 989-791-3888