Provider Demographics
NPI:1235390527
Name:LINDEN, CAREY CHICOREL (MD)
Entity Type:Individual
Prefix:DR
First Name:CAREY
Middle Name:CHICOREL
Last Name:LINDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAREY
Other - Middle Name:K
Other - Last Name:CHICOREL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:31730 HOOVER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-1700
Mailing Address - Country:US
Mailing Address - Phone:586-268-9222
Mailing Address - Fax:586-268-9226
Practice Address - Street 1:31730 HOOVER RD
Practice Address - Street 2:SUITE A
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-1700
Practice Address - Country:US
Practice Address - Phone:586-268-9222
Practice Address - Fax:586-268-9226
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091401207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0305024781OtherBCN IND
MI1235390527Medicaid
MI0305024781OtherBCBS IND PIN
MIN60590003Medicare PIN