Kristina Rae Vander Mark
Obstetrician & Gynecologist Gynecologist Obstetrician
22255 Greenfield Rd Ste 352
Southfield
, Michigan 48075-3712
Kristina Rae Vander Mark
Obstetrician & Gynecologist Gynecologist Obstetrician
22255 Greenfield Rd Ste 352
Southfield
, Michigan 48075-3712
(248) 849-4106
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About
Features
Specialties
- Obstetrician & Gynecologist
- Gynecologist
- Obstetrician
Languages spoken
- English
Location
First Address
- Kristina Rae Vander Mark
- 22255 Greenfield Rd Ste 352
- Southfield, MI
- Zip : 48075-3712
- Fax : (248) 849-4106
- Phone : (248) 849-3401
Second Address
- Kristina Rae Vander Mark
- 22255 Greenfield Rd Ste 352
- Southfield, MI
- Zip : 48075-3712
- Fax : (248) 849-4106
- Phone : (248) 849-3401
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FAQs
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Is Kristina Rae Vander Mark a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207V00000X | Obstetrician & Gynecologist | 4301076692 | MI |
| N | 207VG0400X | Gynecologist | 4301076692 | MI |
| N | 207VX0000X | Obstetrician | 4301076692 | MI |
National Provider Identifier
| NPI | 1366538860 |
|---|---|
| Provider Name | Kristina Rae Vander Mark |
| First Address | Southfield, MI 48075-3712 |
| Second Address | Southfield, MI 48075-3712 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/10/2006 |
| Last Update Date | 03/02/2022 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 4789630 | (05) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.