Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Carol Lynn Lidstrom, PA-C

Individual provider Medical Physician Assistant · NPI 1700192424

MS. Carol Lynn Lidstrom, PA-C is a Medical Physician Assistant in Detroit, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2010
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1 Ford Pl Ste 2E
Detroit, MI 48202-3450
Phone: (313) 937-3049
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5601002244 (MI)

Record details

NPI number1700192424
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 19, 2010
Last updated in NPPESAugust 19, 2010

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