Provider Demographics
NPI:1558398198
Name:CAREY, JOHN ARTHUR (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ARTHUR
Last Name:CAREY
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 1:51 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-9025
Mailing Address - Country:US
Mailing Address - Phone:989-772-1928
Mailing Address - Fax:989-775-8384
Practice Address - Street 1:51 CEDAR DRIVE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-3234
Practice Address - Country:US
Practice Address - Phone:989-772-1928
Practice Address - Fax:989-775-8384
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101008545207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1958560Medicaid
MI1558398198Medicaid
MI0C76009016Medicare ID - Type Unspecified
MI1958560Medicaid
MIMI1609021Medicare PIN