Individual
PATRICK R CARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 364-4200
(616) 364-7347
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67000129
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102563722
ANTHEM PTAN
IN
05
—
2832822
—
OH
01
—
67000129
LICENSE
OH
01
—
784
CERTIFICATION
—
Enumeration date
11/27/2007
Last updated
03/07/2025
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