Provider Demographics
NPI:1376825174
Name:CARETTI, KATHERINE LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LYNN
Last Name:CARETTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20045 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2322
Mailing Address - Country:US
Mailing Address - Phone:313-884-5100
Mailing Address - Fax:313-884-9446
Practice Address - Street 1:20045 MACK AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-2322
Practice Address - Country:US
Practice Address - Phone:313-884-5100
Practice Address - Fax:313-884-9446
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098660207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology