Individual
KIM MARIE PFOTENHAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
965 WILSON RD RM A325, EAST LANSING, MI 48824-6410
(517) 862-2449
Mailing address
5577 STRAWBERRY LN, HASLETT, MI 48840-9773
(517) 862-2449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14181
CA
207Q00000X
Family Medicine Physician
Primary
5101018189
MI
208D00000X
General Practice Physician
5101018189
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/02/2009
Last updated
03/23/2021
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