Provider Demographics
NPI:1548491129
Name:MACFARLANE, KATIE HILL (DO)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:HILL
Last Name:MACFARLANE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:HILL
Other - Last Name:SUMNICHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:DEPT 20390
Mailing Address - Street 2:P O BOX 67000
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-0001
Mailing Address - Country:US
Mailing Address - Phone:248-471-8982
Mailing Address - Fax:248-471-9978
Practice Address - Street 1:23133 ORCHARD LAKE RD STE 200
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-3268
Practice Address - Country:US
Practice Address - Phone:248-579-9220
Practice Address - Fax:248-471-9978
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1548491129Medicaid
MIF37118009Medicare PIN