Provider Demographics
NPI:1902426257
Name:MACMILLAN, KATHARINE E (DO)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:E
Last Name:MACMILLAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2429 TRAUTNER DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-9596
Mailing Address - Country:US
Mailing Address - Phone:989-583-5514
Mailing Address - Fax:989-583-1742
Practice Address - Street 1:2429 TRAUTNER DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9596
Practice Address - Country:US
Practice Address - Phone:989-583-5514
Practice Address - Fax:989-583-1742
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101027845207Q00000X
WV4158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine