Individual
KATHRYN ELAINE MICHALCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1811 CHARLTON CT, GOSHEN, IN 46526-6464
(574) 534-8200
(574) 534-0411
Mailing address
1811 CHARLTON CT, GOSHEN, IN 46526-6464
(574) 534-8200
(574) 534-0411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11015152A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201023990
—
IN
Enumeration date
06/30/2009
Last updated
04/16/2018
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