Healthcare Provider Details

I. General information

NPI: 1811975097
Provider Name (Legal Business Name): KATIA NAKAHODO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W UNIVERSITY DR
ROCHESTER MI
48307-1863
US

IV. Provider business mailing address

1101 W UNIVERSITY DR EMERGENCY DEPT
ROCHESTER MI
48307-1863
US

V. Phone/Fax

Practice location:
  • Phone: 248-652-5311
  • Fax:
Mailing address:
  • Phone: 248-652-5311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101014617
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number5101014617
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: