Kidney Center Of Michigan
Nephrology Physician in Pontiac, MI(View on Map)
Legal Business Name
Kidney Center Of Michigan
NPI Number
1083983498
NPI Type
Organization
Enumeration Date
12/14/2011
Specialties
(Taxonomies)Licenses
State
Michigan
License Number
4301084121
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 71026
44555 WOODWARD AVE
City
Rochester Hills
Pontiac
State
MI
MI
Postal Code
48307-0019
48341-5031
Country
US
US
Telephone Number
(248) 858-3011
(248) 858-3011
Authorized Official
Name
Amith Kakulavaram
Title or Position
PRESIDENT
Telephone Number
(248) 858-3011
Identifiers
Identifier
4301084121
Identifier State
MI
Identifier Issuer
LICENSE
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 02/24/2012