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General NPI Number Information
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NPI Number | 1144280959
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Entity Type | Individual
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Provider Name | CYNTHIA L KRESGE P.A.
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3577 W 13 MILE RD SUITE 404
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City | ROYAL OAK
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State | MI
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Zip | 48073-6710
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Country | US
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Telephone | 248-551-6900
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Fax | 248-551-6909
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Provider Business Mailing Address
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Address Line | 1701 SOUTH BLVD E SUITE 350
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-6122
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Country | US
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Telephone | 248-997-9000
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Fax | 248-997-9007
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601001433
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License Number State | MI
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