Individual
DR. DIANA JOLYNN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
100 N POND DR, SUITE C, WALLED LAKE, MI 48390-3079
(248) 624-2222
(248) 926-9455
Mailing address
100 N POND DR, SUITE C, WALLED LAKE, MI 48390-3079
(248) 624-2222
(248) 926-9455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101017651
MI
Other
Enumeration date
10/09/2008
Last updated
04/14/2014
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