Individual
CARLINE MEKEM MBEUMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3412 OFFICE PARK DRIVE, MARION, IL 62959
(618) 993-0404
(618) 993-1717
Mailing address
3412 OFFICE PARK DRIVE, MARION, IL 62959
(618) 993-0404
(618) 993-1717
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036140445
IL
208000000X
Pediatrics Physician
4301103909
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036140445
—
IL
Enumeration date
07/18/2013
Last updated
11/07/2016
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