Provider Demographics
NPI:1821034166
Name:CARAFELLI, MARC ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:ANTHONY
Last Name:CARAFELLI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 W JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2804
Mailing Address - Country:US
Mailing Address - Phone:734-676-4100
Mailing Address - Fax:734-676-4144
Practice Address - Street 1:2711 W JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2804
Practice Address - Country:US
Practice Address - Phone:734-676-4100
Practice Address - Fax:734-676-4144
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008367111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P25100Medicare ID - Type Unspecified