Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301080650 | MI |
N | 207YS0123X | Facial Plastic Surgeon | 4301080650 | MI |
NPI | 1568670156 |
---|---|
Provider Name | Dr. Michael Adelard Carron |
First Address | Detroit, MI 48201-2136 |
Second Address | Dearborn, MI 48124-4089 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 16/10/2019 |