Organization
CARMICHEAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRYSTAL CARMICHEAL MD (PRESIDENT)
(618) 398-6266
Entity
Organization
Contact information
Practice address
8601 WEST MAIN ST., STE. 101, BELLEVILLE, IL 62223
(618) 398-6266
Mailing address
8601 WEST MAIN ST., STE. 101, BELLEVILLE, IL 62223
(618) 398-6266
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036.127381
IL
Other
Enumeration date
10/12/2011
Last updated
07/18/2012
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