Healthcare Provider Details

I. General information

NPI: 1265455869
Provider Name (Legal Business Name): KARLIS E AUSTRINS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W SAGINAW ST # 5
LANSING MI
48915-2033
US

IV. Provider business mailing address

2044 WOODFIELD RD
OKEMOS MI
48864-3227
US

V. Phone/Fax

Practice location:
  • Phone: 517-887-5922
  • Fax:
Mailing address:
  • Phone: 989-996-0499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101015222
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: