Provider Demographics
NPI:1063498319
Name:SARNACKI, CARL C (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:C
Last Name:SARNACKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1455 S LAPEER RD
Mailing Address - Street 2:STE 100
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-1467
Mailing Address - Country:US
Mailing Address - Phone:248-693-3551
Mailing Address - Fax:248-693-4643
Practice Address - Street 1:1455 S LAPEER RD
Practice Address - Street 2:STE 100
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-1467
Practice Address - Country:US
Practice Address - Phone:248-693-3551
Practice Address - Fax:248-693-4643
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301055099207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0806364931OtherBCBS
MI120397OtherPREFERRED CHOICES
MI4480905OtherAETNA
MI0806337511OtherBCBS
MIP00392314OtherRAILROAD MEDICARE GROUP
MIF30122OtherHAP
MI0806364931OtherBCN
MI0806337511OtherBCN
MI0806337511OtherBCN
MI4480905OtherAETNA