Provider Demographics
NPI:1982196101
Name:HOWARD, KATHRYN (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:HOWARD
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 1:2651 CHEROKEE HILLS CIR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-3190
Mailing Address - Country:US
Mailing Address - Phone:651-769-5619
Mailing Address - Fax:
Practice Address - Street 1:200 ELIZABETH STREET
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:ONTARIO
Practice Address - Zip Code:M5G 2C4
Practice Address - Country:CA
Practice Address - Phone:651-769-5619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301115532208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery