Individual
DR. MARY KATHLEEN KNEISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
24108 GREATER MACK AVE, SAINT CLAIR SHORES, MI 48080-1410
(586) 443-5686
(586) 443-5689
Mailing address
24108 GREATER MACK AVE, SAINT CLAIR SHORES, MI 48080-1410
(586) 443-5686
(586) 443-5689
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301051497
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383581109
TAX ID
MI
Enumeration date
06/19/2006
Last updated
01/31/2025
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