Individual
MICHELLE KRISTINE KUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
25599 KELLY RD, SUITE A, ROSEVILLE, MI 48066-4975
(586) 772-6000
(586) 772-7700
Mailing address
25599 KELLY RD, SUITE A, ROSEVILLE, MI 48066-4975
(586) 772-6000
(586) 772-7700
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601003976
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601003976
PHYSICIAN ASST LICENSE
MI
01
—
CD7957
RAILROAD MEDICARE
MI
01
—
CD7959
RAILROAD MEDICARE
MI
Enumeration date
01/11/2007
Last updated
10/19/2007
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