Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 2901016067 | MI |
Y | 213EG0000X | General Practice | 2901016067 | MI |
NPI | 1003906314 |
---|---|
Provider Name | Dr. Theresa Ditrapani Caruana |
First Address | Saint Clair Shores, MI 48081-3371 |
Second Address | Saint Clair Shores, MI 48081-3371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2006 |
Last Update Date | 08/07/2007 |