Provider Demographics
NPI:1427048982
Name:ERLICH, KATHERINE H (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:H
Last Name:ERLICH
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 1:32710 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-1136
Mailing Address - Country:US
Mailing Address - Phone:248-254-6646
Mailing Address - Fax:248-254-6646
Practice Address - Street 1:32710 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MI
Practice Address - Zip Code:48025-1136
Practice Address - Country:US
Practice Address - Phone:248-254-6646
Practice Address - Fax:248-254-6646
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065516208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4269658Medicaid
0N18600Medicare ID - Type Unspecified
MI4269658Medicaid