Individual
KATHERINE ANN JAWOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
17325 VAN WAGONER RD, SPRING LAKE, MI 49456-9702
(616) 364-1500
(616) 364-6400
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5101012270
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102239
VALUE OPTIONS
MI
01
—
214510000
MAGELLAN
MI
01
—
2656100914
BCBS MI
MI
01
—
383621541
ASR
MI
05
—
4765010
—
MI
Enumeration date
06/05/2006
Last updated
06/17/2013
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