Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4301091401 | MI |
N | 208000000X | Pediatrician | 4301091401 | MI |
NPI | 1235390527 |
---|---|
Provider Name | Dr. Carey Chicorel Linden |
First Address | Warren, MI 48093-1700 |
Second Address | Warren, MI 48093-1700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2008 |
Last Update Date | 28/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0305024781 | BCBS IND PIN (01) | MI |
0305024781 | BCN IND (01) | MI |
1235390527 | (05) | MI |