Individual
CARLA DIANE BIBART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22301 FOSTER WINTER DRIVE, FLOOR 1, SOUTHFIELD, MI 48075-3713
(248) 849-3321
(248) 849-8448
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005302
MI
Other
Enumeration date
05/25/2010
Last updated
12/05/2018
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