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Individual

ANNE M JOANNIDESCARBAJO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1080 KIRTS BLVD, SUITE# 400, TROY, MI 48084-4881
(248) 362-2660
(248) 362-0662
Mailing address
1080 KIRTS BLVD, SUITE# 400, TROY, MI 48084-4881
(248) 362-2660
(248) 362-0662

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
4301065636
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4301065636
STATE LIC. #
MI
Enumeration date
11/30/2006
Last updated
03/07/2023
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