Individual
MS. KIMBER M GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
610 S LINCOLN RD, ESCANABA, MI 49829-1215
(906) 786-6488
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301082649
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4545812
—
MI
01
—
KG082649
BCBS OF MICHIGAN
MI
01
—
P00064002
RAILROAD MEDICARE
MI
Enumeration date
09/07/2005
Last updated
07/26/2022
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