Jenkins-Mosure, Kristan Gail

Jenkins-Mosure, Kristan Gail is an individual health care provider with primary practice located at 2799 W Grand Blvd , Detroit MI 48202-2608. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Jenkins-Mosure, Kristan Gail can be contacted via phone (800) 653-6568.

Contact Information

Primary practice address
2799 W Grand Blvd Detroit MI 48202-2608
Phone: (800) 653-6568
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X 4301088572 Michigan
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X 35098978 Ohio
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 35098978 Ohio
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 4301088572 Michigan

Profile Details

NPI number 1013145853
LBN Legal business name Jenkins-Mosure, Kristan Gail
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2009
Last updated Apr 19th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013145853 NPPES
Ohio Other 35098978 OH MEDICAL LICENSE
Ohio MEDICAID 0067438 OH MEDICAL LICENSE

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