Provider Demographics
NPI:1386013142
Name:GARCHOW, CARRIE (PA)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:GARCHOW
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:2480 ROSEWOOD N
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-5003
Mailing Address - Country:US
Mailing Address - Phone:989-775-3823
Mailing Address - Fax:989-773-5061
Practice Address - Street 1:2480 ROSEWOOD N
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-5003
Practice Address - Country:US
Practice Address - Phone:989-775-3823
Practice Address - Fax:989-773-5061
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601007527363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant