MEDICARE: DR. CYNTHIA KNAPP M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	4301061761	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0103710612	OTHER	MI	BCBSM
3	0108132312	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1194776203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA KNAPP M.D.

Provider Business Mailing Address
First Line	:	1750 E BELLOWS ST
Second Line	:	STE. G
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-3872
Country	:	US
Telephone Number	:	989-773-9669
Fax Number	:

Provider Business Practice Location Address
First Line	:	7053 TYRRELL RD
Second Line	:
City	:	LAINGSBURG
State	:	MI
Zip	:	48848-9805
Country	:	US
Telephone Number	:	517-651-6462
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	11/14/2012

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