Provider Demographics
NPI:1750965471
Name:SIMLER, CARMEN CHRISTINE (PA-C)
Entity type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:CHRISTINE
Last Name:SIMLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3455 N WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6750
Mailing Address - Country:US
Mailing Address - Phone:248-288-9340
Mailing Address - Fax:
Practice Address - Street 1:3535 W 13 MILE RD STE 247
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6770
Practice Address - Country:US
Practice Address - Phone:248-288-9340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-09
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601010483363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant