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General NPI Number Information
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NPI Number | 1306805866
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Entity Type | Individual
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Provider Name | ANNETTE CARRON DO
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Gender | Female
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 28080 GRAND RIVER AVE SUITE 306
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-5966
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Country | US
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Telephone | 734-464-0887
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Fax | 734-402-0254
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Provider Business Mailing Address
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Address Line | 36123 SCHOOLCRAFT RD
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City | LIVONIA
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State | MI
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Zip | 48150-1216
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Country | US
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Telephone | 734-464-0887
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Fax | 734-402-0254
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 5101011445
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License Number State | MI
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