Basic Information
| Provider Information | |||||||||
| NPI: | 1699075622 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARKIN-JOSEPH | ||||||||
| FirstName: | CARLA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| OtherLastName: | PARKIN | ||||||||
| OtherFirstName: | CARLA | ||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3621 S STATE ST | ||||||||
| Address2: | 700 KMS PLACE | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349362047 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1500 E MEDICAL CENTER DR | ||||||||
| Address2: | 12TH FLOOR CS MOTT CHILDRENS HOSPITAL RM 525 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481094280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347635302 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2010 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080C0008X | MT207077 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | Child Abuse Pediatrics | 2080C0008X | 4301096951 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics | Child Abuse Pediatrics | 208000000X | 4301096951 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.