Anne M Joannidescarbajo
Adolescent Medicine
1080 Kirts Blvd Suite# 400
Troy
, Michigan 48084-4881
Anne M Joannidescarbajo
Adolescent Medicine
1080 Kirts Blvd Suite# 400
Troy
, Michigan 48084-4881
(248) 362-0662
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Anne M Joannidescarbajo
- 1080 Kirts Blvd Suite# 400
- Troy, MI
- Zip : 48084-4881
- Fax : (248) 362-0662
- Phone : (248) 362-2660
Second Address
- Anne M Joannidescarbajo
- 1080 Kirts Blvd Suite# 400
- Troy, MI
- Zip : 48084-4881
- Fax : (248) 362-0662
- Phone : (248) 362-2660
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Is Anne M Joannidescarbajo a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | 4301065636 | MI |
National Provider Identifier
| NPI | 1205903325 |
|---|---|
| Provider Name | Anne M Joannidescarbajo |
| First Address | Troy, MI 48084-4881 |
| Second Address | Troy, MI 48084-4881 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/11/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 4301065636 | STATE LIC. # (01) | MI |
| BJ6143236 | DEA LIC. # (01) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.