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Individual
KRISTINA RAE VANDER MARK
Active
Individual
KRISTINA RAE VANDER MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
4301076692
MI
207V00000X
Obstetrics & Gynecology Physician
Primary
ME170074
FL
207VG0400X
Gynecology Physician
4301076692
MI
207VX0000X
Obstetrics Physician
4301076692
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4789630
—
MI
Enumeration date
10/04/2006
Last updated
02/18/2025
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