Individual
KATHRYN VISCONTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3000
Mailing address
1500 E. MEDICAL CENTER DRIVE, 1H 247 UH, ANN ARBOR, MI 48109-5048
(734) 936-4280
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5101027909
MI
390200000X
Student in an Organized Health Care Education/Training Program
5151014569
MI
Other
Enumeration date
06/17/2020
Last updated
05/10/2024
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