Provider Demographics
NPI:1376525717
Name:KITAIN, DONALD S (DO)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:S
Last Name:KITAIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:9640 COMMERCE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-4111
Mailing Address - Country:US
Mailing Address - Phone:248-360-8825
Mailing Address - Fax:248-360-8897
Practice Address - Street 1:9640 COMMERCE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-4111
Practice Address - Country:US
Practice Address - Phone:248-360-8825
Practice Address - Fax:248-360-8897
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIDK008753207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0456330364OtherBLUE CARE NETWORK
MIDK008753OtherPHYSICIAN LICENSE
MIM014782OtherTRICARE HEALTHNET
MI0456330364OtherBCBS OF MICHIGAN
MI4498389002OtherCIGNA
MI01001880OtherHEALTH PLUS
MI102401OtherCARE CHOICES HMO PPO
MI1876910Medicaid
MI4629785OtherAETNA
MI102401OtherCARE CHOICES HMO PPO
MIP42090001Medicare ID - Type UnspecifiedMEDICARE ID
MI1876910Medicaid