CARL D HARLAN JR. (NPI# 1730147307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730147307 |
| Entity Type | Individual |
| Full Name | CARL D HARLAN JR. |
| Credential | DO |
| Practice Address |
14700 Lake Shore Dr Charlevoix MI 49720 |
| Mailing Address |
Po Box 1108 Ann Arbor MI 48106-1108 |
| Practice Telephone | 2315474024 |
| Practice Fax Number | 7346777407 |
| Mailing Telephone | 2315474024 |
| Mailing Fax Number | 7346777407 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2008-05-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
5101008593 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RR MEDICARE | 300086775 | 01 |
| MI | HEALTHPOLUS | 0982318 | 01 |
| MI | BCBS INDIVIDUAL ID | 3151500034 | 01 |
| MI | BCBS | 310A510270 | 01 |
| MI | 3450062 | 05 | |
| MI | MEDICARE RR PIN | 300086775 | 01 |
| Street Address |
14700 LAKE SHORE DR |
| City | CHARLEVOIX |
| State | MI |
| Zip Code | 49720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528065034 | Thomas G Ling | Internal Medicine | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2005-06-30 |
| 1477163392 | Tracey Allers | Physical Therapist | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2020-08-05 |
| 1518581610 | David L Grof | Physical Therapist | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2020-06-04 |
| 1366944118 | Carolyn Ann Navarre | Physical Therapist | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2018-03-07 |
| 1720589393 | Marla Ane Marrs | Occupational Therapist | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2018-02-28 |
| 1720589740 | Kathleen Grace Haas | General Acute Care Hospital | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2018-02-25 |
| 1831690023 | Tracey Sherman | Physical Therapist | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2018-02-23 |
| 1982105169 | Andrew Funsch | Physical Therapist | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2018-02-23 |
| 1902307259 | Karyn Lynn Dunlap | Occupational Therapist | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2018-02-22 |
| 1154822484 | Candice Wiers | Physical Therapist | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2018-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477488 | Munson Healthcare Charlevoix Hospital | Urology | 11695 Park Ave, Suite A, Charlevoix, MI 49720 | 2020-11-06 |
| 1215587498 | Amanda Evans | Dietitian, Registered | 09210 North Pointe Woods Drive, Charlevoix, MI 49720 | 2019-09-18 |
| 1508229980 | Charlevoix Physicians Clinic | Specialist | 14709 W. Upright, Charlevoix, MI 49720 | 2016-04-01 |
| 1881014348 | Tracy Skinner | Social Worker | 220 W. Garfield Ave, Charlevoix, MI 49720 | 2014-04-23 |
| 1720414097 | Jennifer Jean Swenor | Occupational Therapist | 10270 Burnett Rd, Charlevoix, MI 49720 | 2013-09-18 |
| 1801171863 | Leslie Lukins | Pharmacist | 1500 Bridge Street, Charlevoix, MI 49720 | 2011-10-20 |
| 1164670949 | Northwest Michigan Community Health Agency | Hospice Care, Community Based | 220 W Garfield Street, Charlevoix, MI 49720 | 2008-09-04 |
| 1275722191 | Robert Dennis Cook | Pharmacist | 301 Bridge Street, Charlevoix, MI 49720 | 2007-10-16 |
| 1629191648 | Susan Mary Killam | Nurse Practitioner | Northwest Michigan Community Health Agency, 220 W. Garfield Street, Charlevoix, MI 49720 | 2007-04-06 |
| 1851410153 | Joelle M Beaudoin | Specialist/Technologist | 06510 M-66 N, Charlevoix, MI 49720 | 2007-03-28 |
| Find all providers in zip 49720 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855667 | Joshua Boulter | Radiology | 2250 Providence Drive, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-11 |
| 1679197693 | Shyam Amin | Radiology | Academic Internal Medicine 2 2250 Providence Dr, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-05 |
| 1871116509 | Anthony Diebes | Radiology | 16001 W 9 Mile Rd Bldg 4th, Southfield, MI 48075-4818 | 2020-05-28 |
| 1548823800 | Alexander Paul Kaechele | Radiology | 16001 West 9 Mile Road, Suite #416, Southfield, MI 48075-4818 | 2019-04-22 |
| 1790246627 | Genesis Healthcare | Radiology | 8560 N Silvery Ln Ste 101, Dearborn Heights, MI 48127-4516 | 2019-03-25 |
| 1023572831 | Proscan Imaging Southfield Pllc | Radiology | 29877 Telegraph Rd # 11, Southfield, MI 48034-1332 | 2019-01-25 |
| 1295204253 | Easy Imaging, LLC | Radiology | 16100 19 Mile Rd Ste X, Clinton Township, MI 48038-1148 | 2018-11-20 |
| 1205304888 | Ascension Medical Group Genesys | Radiology | 1096 S Belsay Rd Ste J, Burton, MI 48509-1948 | 2018-11-13 |
| 1336626696 | Quantum Medical Radiology of California, P.C. | Radiology | 1625 Bear Creek Ln Unit O, Petoskey, MI 49770-8378 | 2018-07-19 |
| 1376072488 | Cambridge Institute of Minimally Invasive Therapies Pllc | Radiology | 2007 E 14 Mile Rd, Sterling Heights, MI 48310-5905 | 2017-06-12 |
| Find all providers with the same taxonomy | ||||
| City | CHARLEVOIX |
| Zip Code | 49720 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.