Individual
CAROLYN M VALOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3500 FRANCISCAN WAY STE 400, MICHIGAN CITY, IN 46360-0033
(219) 861-8785
(219) 861-8789
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001024A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000636955
ANTHEM BLUE CROSS BLUE SHIELD
IN
05
—
300006683
—
IN
01
—
P01192139
RR MEDICARE PTAN
IN
Enumeration date
08/13/2008
Last updated
12/02/2024
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