Provider Demographics
NPI:1194776203
Name:KNAPP, CYNTHIA (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:KNAPP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 E BELLOWS ST
Mailing Address - Street 2:STE. G
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-3872
Mailing Address - Country:US
Mailing Address - Phone:989-773-9669
Mailing Address - Fax:
Practice Address - Street 1:7053 TYRRELL RD
Practice Address - Street 2:
Practice Address - City:LAINGSBURG
Practice Address - State:MI
Practice Address - Zip Code:48848-9805
Practice Address - Country:US
Practice Address - Phone:517-651-6462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301061761207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4157295Medicaid
MI0103710612OtherBCBSM
MI0108132312OtherBCBSM
MIP59290001Medicare PIN
MI0103710612OtherBCBSM