Provider Demographics
NPI:1962679811
Name:HOPPER, KATRIINA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:KATRIINA
Middle Name:MARIE
Last Name:HOPPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATRIINA
Other - Middle Name:MARIE
Other - Last Name:WILLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:500 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-1569
Mailing Address - Country:US
Mailing Address - Phone:906-483-1730
Mailing Address - Fax:906-483-1270
Practice Address - Street 1:500 CAMPUS DR
Practice Address - Street 2:SUITE 4
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1569
Practice Address - Country:US
Practice Address - Phone:906-483-1730
Practice Address - Fax:906-483-1270
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301103973207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine