| Kyle Antosiek Do Pc | |
|
5680 Bow Pointe Dr Ste 102 Clarkston MI 48346-5407 | |
| (248) 221-1845 | |
| (833) 645-2176 |
| Full Name | Kyle Antosiek Do Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5680 Bow Pointe Dr Ste 102, Clarkston, Michigan |
| Authorized Official Name and Position | Kyle Antosiek (OWNER) |
| Authorized Official Contact | 5866306551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Antosiek Do Pc 5680 Bow Pointe Dr Ste 102 Clarkston MI 48346-5407 Ph: (248) 221-1845 | Kyle Antosiek Do Pc 5680 Bow Pointe Dr Ste 102 Clarkston MI 48346-5407 Ph: (248) 221-1845 |
| NPI Number | 1871243931 |
|---|---|
| Provider Enumeration Date | 03/23/2022 |
| Last Update Date | 07/25/2022 |
| Medicare PECOS PAC ID | 3476940289 |
|---|---|
| Medicare Enrollment ID | O20220426001959 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871243931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Kyle Edward Antosiek |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376926972 PECOS PAC ID: 2062703101 Enrollment ID: I20220426002016 |
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