Provider Demographics
NPI:1295902591
Name:KOUNTANIS, ELAINE CONSTANCE (MD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:CONSTANCE
Last Name:KOUNTANIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5395 GREEN PINE LN
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-4576
Mailing Address - Country:US
Mailing Address - Phone:269-372-1386
Mailing Address - Fax:269-372-1386
Practice Address - Street 1:5395 GREEN PINE LN
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-4576
Practice Address - Country:US
Practice Address - Phone:269-372-1386
Practice Address - Fax:269-372-1386
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301405565202C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner