Healthcare Provider Details

I. General information

NPI: 1003091141
Provider Name (Legal Business Name): MONROE EAR, NOSE AND THROAT ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 N MACOMB ST SUITE 320
MONROE MI
48162-2900
US

IV. Provider business mailing address

730 N MACOMB ST SUITE 320
MONROE MI
48162-2900
US

V. Phone/Fax

Practice location:
  • Phone: 734-243-5020
  • Fax: 734-457-1970
Mailing address:
  • Phone: 734-243-5020
  • Fax: 734-457-1970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DR. AMDREW KARPENKO
Title or Position: PRESIDENT
Credential: MD
Phone: 734-243-5020