Provider Demographics
NPI:1891826228
Name:KING FLATH, KRISTI ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:ANN
Last Name:KING FLATH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTI
Other - Middle Name:ANN
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7870W US HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:MANISTIQUE
Mailing Address - State:MI
Mailing Address - Zip Code:49854-8992
Mailing Address - Country:US
Mailing Address - Phone:906-341-1876
Mailing Address - Fax:906-341-1878
Practice Address - Street 1:7870W US HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:MANISTIQUE
Practice Address - State:MI
Practice Address - Zip Code:49854-8992
Practice Address - Country:US
Practice Address - Phone:906-341-1876
Practice Address - Fax:906-341-1878
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301093865207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP38340036Medicare Oscar/Certification