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MS. CAROL LYNN LIDSTROM PA-C
NPI 1700192424
Physician Assistant - Medical in Detroit, MI

Active since August 19, 2010
1 FORD PL, SUITE 2E, DETROIT, MI 48202(313) 937-3049 Get Directions Write a Review

NPPES record last updated: August 19, 2010. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Ms. Carol Lynn Lidstrom Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. CAROL LYNN LIDSTROM PA-C (NPI 1700192424) is an individual medical provider in Detroit, Michigan, licensed in Michigan (5601002244) and active in the NPI registry since August 2010.

NPPES Registry Identity

NPI1700192424
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMS. CAROL LYNN LIDSTROMCredential: PA-C
Location Address1 FORD PL, SUITE 2EDetroit, MI 48202-3450
Mailing Address3139 S Wayne RdWayne, MI 48184-1220 · (734) 722-2722 · Fax (734) 722-7006
Phone(313) 937-3049
Sole ProprietorYes
Enumeration DateAugust 19, 2010
✔ NPI 1700192424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in MI · 5601002244
1 FORD PL, Detroit, MI 48202
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIANE LOECKNER LLP
Psychologist (Counseling)
1 FORD PL, STE 1 C
DETROIT, MI 48202
Wayne County (313) 876-7605
DR. PINO D. COLONE M.D.
Emergency Medicine
1 FORD PL
DETROIT, MI 48202
Wayne County (313) 916-2522
HENRY FORD BEHAVIORAL HEALTH- ONE FORD PLACE
Clinic/Center
1 FORD PL, SUITE 1 C
DETROIT, MI 48202
Wayne County (313) 874-8377
MRS. ALTHEA KIMBROUGH NP
Nurse Practitioner
1 FORD PL
DETROIT, MI 48202
Wayne County (313) 433-5443
BETHANY THAYER
Dietitian, Registered
1 FORD PL
DETROIT, MI 48202
Wayne County (248) 224-1113
MA'KHYA CULBREATH
Community Health Worker
1 FORD PL
DETROIT, MI 48202
Wayne County (313) 874-4118
BRENT FUNK PSY.D.
Psychologist (Clinical)
1 FORD PL, 1E
DETROIT, MI 48202
Wayne County (313) 874-6651
SYDNEY AUTUMN LIPSEY LMSW
Social Worker (Clinical)
1 FORD PL, SUITE I C
DETROIT, MI 48202
Wayne County (313) 874-6677

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carol Lidstrom's NPI number?

The NPI number for Carol Lidstrom is 1700192424. It was assigned to this individual provider in the NPPES registry on August 19, 2010.

Where is Carol Lidstrom located?

Carol Lidstrom practices at 1 Ford Pl Suite 2E, Detroit, MI 48202. The listed phone number is (313) 937-3049.

What is Carol Lidstrom's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Carol Lidstrom was last updated on August 19, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.