Provider Demographics
NPI:1740270974
Name:GUIDOT, CAROLYN E (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:E
Last Name:GUIDOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:18161 W 13 MILE RD
Mailing Address - Street 2:STE E1
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1113
Mailing Address - Country:US
Mailing Address - Phone:248-642-8989
Mailing Address - Fax:248-642-8989
Practice Address - Street 1:18161 W 13 MILE RD
Practice Address - Street 2:STE E1
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1113
Practice Address - Country:US
Practice Address - Phone:248-642-8989
Practice Address - Fax:248-642-8989
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI047604207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0630431Medicare ID - Type Unspecified
A75439Medicare UPIN