Provider Demographics
NPI:1497915680
Name:CARL M. KAROUB, M.D., P.C.
Entity Type:Organization
Organization Name:CARL M. KAROUB, M.D., P.C.
Other - Org Name:CARL KAROUB M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAROUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-288-2160
Mailing Address - Street 1:4045 W 13 MILE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6640
Mailing Address - Country:US
Mailing Address - Phone:248-288-2160
Mailing Address - Fax:248-288-0783
Practice Address - Street 1:4045 W 13 MILE RD
Practice Address - Street 2:SUITE A
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6640
Practice Address - Country:US
Practice Address - Phone:248-288-2160
Practice Address - Fax:248-288-0783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301042923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4300210OtherAETNA
MIDP3243OtherRAILROAD MEDICARE
MIA76139OtherHAP
MI4300210OtherAETNA
MIDP3243OtherRAILROAD MEDICARE
MIA76139Medicare UPIN