Provider Demographics
NPI:1275540825
Name:GARNER, CORRINE ELIZABETH (DO)
Entity Type:Individual
Prefix:
First Name:CORRINE
Middle Name:ELIZABETH
Last Name:GARNER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 TEMPLE ST
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-8624
Mailing Address - Country:US
Mailing Address - Phone:517-244-1000
Mailing Address - Fax:517-244-1030
Practice Address - Street 1:710 TEMPLE ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-8624
Practice Address - Country:US
Practice Address - Phone:517-244-1000
Practice Address - Fax:517-244-1030
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine