Provider Demographics
NPI:1689022469
Name:CARO HEALTH PLAZA PLC
Entity Type:Organization
Organization Name:CARO HEALTH PLAZA PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVEED
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHFOOOZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-672-2100
Mailing Address - Street 1:1525 W CARO RD
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-9686
Mailing Address - Country:US
Mailing Address - Phone:989-672-2100
Mailing Address - Fax:989-672-2120
Practice Address - Street 1:1525 W CARO RD
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-9686
Practice Address - Country:US
Practice Address - Phone:989-672-2100
Practice Address - Fax:989-672-2120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1659326395Medicaid
MI1689022469Medicaid
MI0P26070Medicare PIN
MI1659326395Medicaid