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Individual
HEATHER M KATHAWA
Active
Individual
HEATHER M KATHAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006579
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12501261
CAQH
MI
Enumeration date
02/14/2013
Last updated
05/09/2016
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