National Provider Identifier Database

ELIZABETH M CARLSON, PA-C – NPI #1316346752
Surgical


Contact Information

ELIZABETH M CARLSON, PA-C
235 WEALTHY ST SE
GRAND RAPIDS, MI49503-5247
Phone: 616-840-8224
Fax: 616-840-9690
Website:
Specialty Taxonomy Code
* Surgical 363AS0400X
Physician Assistant 363A00000X

* Indicates primary specialty

NPI Profile & details for ELIZABETH M CARLSON

NPI Number 1316346752
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/21/2014
Last updated 05/28/2026 - About 2 weeks ago
Sole proprietor1 No
Identifiers
  • WI License #: 3404
  • MI Medicaid: 1316346752
  • MI Other: EB007542 BCBS
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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