Provider Demographics
NPI:1750760542
Name:DAS, KATHRYN OPAL (DO)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:OPAL
Last Name:DAS
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1215 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1811
Mailing Address - Country:US
Mailing Address - Phone:517-364-3380
Mailing Address - Fax:517-364-3399
Practice Address - Street 1:1215 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912
Practice Address - Country:US
Practice Address - Phone:517-364-3380
Practice Address - Fax:517-364-3399
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2023-04-27
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Provider Licenses
StateLicense IDTaxonomies
MI5101021546207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine