| T N Kakish Md Pc | |
|
32121 Woodward Ave Suite 204 Royal Oak MI 48073-6237 | |
| (248) 399-5492 | |
| (248) 399-5792 |
| Full Name | T N Kakish Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 32121 Woodward Ave, Royal Oak, Michigan |
| Authorized Official Name and Position | Tariq Kakish (OWNER PHYSICIAN) |
| Authorized Official Contact | 2483995492 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| T N Kakish Md Pc 32121 Woodward Ave Suite 204 Royal Oak MI 48073-6237 Ph: (248) 399-5492 | T N Kakish Md Pc 32121 Woodward Ave Suite 204 Royal Oak MI 48073-6237 Ph: (248) 399-5492 |
| NPI Number | 1629146493 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 08/14/2015 |
| Medicare PECOS PAC ID | 9638161953 |
|---|---|
| Medicare Enrollment ID | O20070117000351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629146493 | NPI | - | NPPES |
| 110F338390 | Other | MI | BCN GROUP |
| 1629146493 | Medicaid | MI | |
| DG3482 | Other | MI | MEDICARE RAILROAD |
| 110F338390 | Other | MI | BC GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301067872 (Michigan) | Primary |
| Provider Name | Tariq N Kakish |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780752543 PECOS PAC ID: 6709778095 Enrollment ID: I20040330000383 |
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