Healthcare Provider Details

I. General information

NPI: 1689022469
Provider Name (Legal Business Name): CARO HEALTH PLAZA PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2016
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 W CARO RD
CARO MI
48723-9686
US

IV. Provider business mailing address

1525 W CARO RD
CARO MI
48723-9686
US

V. Phone/Fax

Practice location:
  • Phone: 989-672-2100
  • Fax: 989-672-2120
Mailing address:
  • Phone: 989-672-2100
  • Fax: 989-672-2120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NAVEED MAHFOOOZ
Title or Position: OWNER
Credential: MD
Phone: 989-672-2100