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Individual

KRISTINA E GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
44000 W 12 MILE RD, SUITE 111, NOVI, MI 48377-2644
(248) 347-8233
(248) 347-8174
Mailing address
44000 W 12 MILE RD, SUITE 111, NOVI, MI 48377-2644
(248) 347-8233
(248) 347-8174

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
36003381
OH
213E00000X
Podiatrist
Primary
5901002628
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0697670001
DURABLE MEDICAL EQUIPMENT
OH
05
2501804
OH
Enumeration date
07/19/2005
Last updated
02/28/2017
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