Individual
CARLEN GOMEZ FIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, C.S. MOTT CHILDRENS HOSPITAL 11TH FLOOR ROOM 661, ANN ARBOR, MI 48109-5204
(734) 764-5176
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301059495
MI
2080P0202X
Pediatric Cardiology Physician
Primary
4301059495
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3484445
—
MI
Enumeration date
08/08/2006
Last updated
11/21/2012
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