Doctor Name: | DR. KRISTIN S MASCHKE |
NPI Number: | 1992778807 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 4301068537 |
Business Practice Address: | 3040 Bourn St Lewiston, MI - 497568134 |
Business Phone Number: | 9897864877 |
Business Fax Number: | 9897862187 |
Mailing Address: | 829 N Center Ave, Suite 298 GAYLORD |
State: | MI |
Postal Code: | 497351595 |
Phone Number: | 9897317708 |
Fax Number: | 9897317929 |
NPI Enumeration Date: | 02/10/2006 |
NPI Last Update Date: | 12/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301068537 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |