Healthcare Provider Details

I. General information

NPI: 1265774491
Provider Name (Legal Business Name): KATHRYN M KRAUSS-SCHIKORA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN M KRAUSS MD

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 BEAUBIEN 3RD. FLOOR ZMAIN:#3G32 CHILDREN'S HOSPITAL OF MI
DETROIT MI
48201
US

IV. Provider business mailing address

4201 ST. ANTOINE UHC 5D MAILBOX# 226 UNIVERSITY PEDIATRICIANS
DETROIT MI
48201
US

V. Phone/Fax

Practice location:
  • Phone: 313-966-0128
  • Fax: 313-993-0390
Mailing address:
  • Phone: 313-966-5051
  • Fax: 313-966-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301110896
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: