Provider Demographics
NPI:1053571885
Name:KONTOS, NATALIE RENEE (DO)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:RENEE
Last Name:KONTOS
Suffix:
Gender:F
Credentials:DO
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Other - Last Name:
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Mailing Address - Street 1:22201 MOROSS RD
Mailing Address - Street 2:PROFESSIONAL BUILDING 2, SUITE 70
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2169
Mailing Address - Country:US
Mailing Address - Phone:313-343-4279
Mailing Address - Fax:313-343-7937
Practice Address - Street 1:22201 MOROSS RD
Practice Address - Street 2:PROFESSIONAL BUILDING 2, SUITE 70
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2169
Practice Address - Country:US
Practice Address - Phone:313-343-4279
Practice Address - Fax:313-343-7937
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2012-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101017823208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics