Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 30.026425 | OH |
NPI | 1528553302 |
---|---|
Provider Name | Dr. Caroline Marie Michaels |
First Address | Columbus, OH 43214-2814 |
Second Address | Pittsburgh, PA 15261 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2018 |
Last Update Date | 05/05/2021 |