Healthcare Provider Details

I. General information

NPI: 1174589352
Provider Name (Legal Business Name): MICHELE M CARR DDS,MD,PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CISHEI CHILDRENS OUT PATIENT CENTER 1001 MAIN ST 3RD FLOOR
BUFFALO NY
14203
US

IV. Provider business mailing address

CISHEI CHILDRENS OUT PATIENT CENTER 1001 MAIN ST 3RD FLOOR
BUFFALO NY
14203
US

V. Phone/Fax

Practice location:
  • Phone: 716-323-6030
  • Fax: 716-323-6671
Mailing address:
  • Phone: 716-323-6030
  • Fax: 716-323-6671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD421761
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: