Provider Demographics
NPI:1699745455
Name:MONAGHAN, KRISTIN G (PHD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:G
Last Name:MONAGHAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1267 PROSPER DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-2058
Mailing Address - Country:US
Mailing Address - Phone:313-916-3188
Mailing Address - Fax:313-916-1730
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:CFP 4
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-3188
Practice Address - Fax:313-916-1730
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI99106207SG0203X, 207SG0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics
Not Answered207SG0205XAllopathic & Osteopathic PhysiciansMedical GeneticsPh.D. Medical Genetics