Individual
KATHRYN HERRERA THEUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1051 N CANTON CENTER RD, CANTON, MI 48187-5097
(734) 844-5400
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301514173
MI
390200000X
Student in an Organized Health Care Education/Training Program
4351047426
MI
Other
Enumeration date
06/02/2021
Last updated
08/13/2025
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