Vander Mark, Kristina Rae

Vander Mark, Kristina Rae is an individual health care provider with primary practice located at 22255 Greenfield Rd Ste 352 , Southfield MI 48075-3712. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Obstetrics, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Vander Mark, Kristina Rae can be contacted via phone (248) 849-3401.

Contact Information

Primary practice address
22255 Greenfield Rd Ste 352 Southfield MI 48075-3712
Phone: (248) 849-3401
Fax: (248) 849-4106
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 4301076692 Michigan
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 4301076692 Michigan
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 4301076692 Michigan

Profile Details

NPI number 1366538860
LBN Legal business name Vander Mark, Kristina Rae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Feb 3rd, 2022 - about 3 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 1366538860 NPPES
Michigan MEDICAID 4789630

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