Organization
CAROLYN C MOATS, M.D. PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY STARKEY (BILLER)
(231) 933-8805
Entity
Organization
Contact information
Practice address
207 CIRCLE DR, TRAVERSE CITY, MI 49684-2347
(231) 933-8805
(231) 933-8872
Mailing address
207 CIRCLE DR, TRAVERSE CITY, MI 49684-2347
(231) 933-8805
(231) 933-8872
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
074827
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0802810481
BLUE CROSS BLUE SHIELD
MI
05
—
4678167
—
MI
Enumeration date
01/19/2008
Last updated
02/01/2008
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