Provider Demographics
NPI:1437163730
Name:CARELS, HENRY A (DO)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:A
Last Name:CARELS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5322 ABBEY RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-2403
Mailing Address - Country:US
Mailing Address - Phone:248-650-2444
Mailing Address - Fax:248-650-6329
Practice Address - Street 1:239 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ROMEO
Practice Address - State:MI
Practice Address - Zip Code:48065-5130
Practice Address - Country:US
Practice Address - Phone:586-752-2861
Practice Address - Fax:586-752-1867
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006937207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5502373Medicare ID - Type Unspecified
MIE25959Medicare UPIN