Kallenbach, Jeremy

Kallenbach, Jeremy is an individual health care provider with primary practice located at 24681 Northwestern Hwy Ste. 100, Southfield MI 48075-2305. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kallenbach, Jeremy can be contacted via phone (248) 352-2000.

Contact Information

Primary practice address
24681 Northwestern Hwy Ste. 100 Southfield MI 48075-2305
Phone: (248) 352-2000
Fax: (248) 324-1477
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301063038 Michigan

Profile Details

NPI number 1891775730
LBN Legal business name Kallenbach, Jeremy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Sep 5th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891775730 NPPES
Michigan MEDICAID 4403817

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