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Individual

KATHLEEN L. DE BIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
17197 N LAUREL PARK DR, SUITE 161, LIVONIA, MI 48152-2680
(734) 338-8300
(734) 338-8301
Mailing address
17197 N LAUREL PARK DR, SUITE 161, LIVONIA, MI 48152-2680
(734) 338-8300
(734) 338-8301

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002882
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
700H231390
BCBS GROUP NUMBER
MI
Enumeration date
03/23/2007
Last updated
02/27/2012
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