Individual
KAREN L BRONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-8865
(248) 344-2350
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-8865
(248) 344-2350
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50001431
OH
363A00000X
Physician Assistant
Primary
5601003196
MI
363AM0700X
Medical Physician Assistant
50001431
OH
363AS0400X
Surgical Physician Assistant
5601003196
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000587469
ANTHEM
OH
01
—
P00647130
RRMC
OH
01
—
P00864076
RRMC
OH
Enumeration date
10/04/2005
Last updated
10/23/2023
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