Individual
KRISTAN GAIL JENKINS-MOSURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
2213 CHERRY ST, ATTN: MRG ASSOCIATES, LLC - RADIOLOGY DEPT., TOLEDO, OH 43608-2603
(419) 251-2740
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
35098978
OH
2085B0100X
Body Imaging Physician
4301088572
MI
2085R0202X
Diagnostic Radiology Physician
35098978
OH
2085R0202X
Diagnostic Radiology Physician
Primary
4301088572
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067438
—
OH
01
—
35098978
OH MEDICAL LICENSE
OH
Enumeration date
07/01/2009
Last updated
04/19/2022
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