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NPI Code Detail

MEDICARE: KAITLIN SENAWI PA-C

MEDICARE: KAITLIN SENAWI PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601011071MI

General Provider Information

NPI Number : 1376275990
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLIN SENAWI PA-C
Provider Business Mailing Address
First Line : 1 FORD PL STE 3A
Second Line :
City : DETROIT
State : MI
Zip : 48202-3450
Country : US
Telephone Number : 313-874-4806
Fax Number :
Provider Business Practice Location Address
First Line : 15855 19 MILE RD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-3504
Country : US
Telephone Number : 586-263-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2022
Last Update Date : 04/16/2026

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Directions to “ KAITLIN SENAWI PA-C” Practice Location

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