Individual
CAROL SOUTHLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1223 MERCY DR, MUSKEGON, MI 49444-1829
(231) 672-3177
Mailing address
PO BOX 1848, MUSKEGON, MI 49443-1848
(231) 727-4444
(231) 728-4789
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301034132
MI
Other
Enumeration date
12/22/2005
Last updated
09/11/2014
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