Provider Demographics
NPI:1174781280
Name:ZIEGLER, KATHRYN M (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:M
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:MARIE
Other - Last Name:DALBEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1695 12 MILE RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-1200
Mailing Address - Country:US
Mailing Address - Phone:248-551-8180
Mailing Address - Fax:248-551-8181
Practice Address - Street 1:1695 12 MILE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1200
Practice Address - Country:US
Practice Address - Phone:248-551-8180
Practice Address - Fax:248-551-8181
Is Sole Proprietor?:No
Enumeration Date:2008-05-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11013233A208600000X
IN01066991A208600000X
MI4301106336208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201103680Medicaid
IN201103680Medicaid
IN201103680Medicaid
IN233690026Medicare PIN