Individual
DR. LOREN J DECARLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
117 S MAIN ST, CAPAC, MI 48014-3715
(810) 395-4840
(810) 395-7551
Mailing address
117 S MAIN ST, CAPAC, MI 48014-3715
(810) 395-4840
(810) 395-7551
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101013942
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4735675
—
MI
Enumeration date
07/11/2006
Last updated
03/21/2011
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