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General NPI Number Information
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NPI Number | 1508034232
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Entity Type | Individual
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Provider Name | FRANCISCA M.S. KARTONO WINARDI D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 133 W MAIN ST STE 251
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City | NORTHVILLE
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State | MI
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Zip | 48167-1575
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Country | US
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Telephone | 248-963-5915
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Fax | 248-278-4854
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Provider Business Mailing Address
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Address Line | 133 W MAIN ST STE 251
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City | NORTHVILLE
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State | MI
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Zip | 48167-1575
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Country | US
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Telephone | 248-963-5915
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Fax | 248-278-4854
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 5101017339
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License Number State | MI
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