Koltonow, Sanford

Koltonow, Sanford is an sole proprietor health care provider with primary practice located at 31815 Southfield Rd Ste 24 , Beverly Hills MI 48025-5471. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Psychiatry, Behavioral Health & Social Service Providers / Psychoanalysis. Behavioral Health & Social Service Providers / Psychoanalysis is his primary health care specialty. Koltonow, Sanford can be contacted via phone (248) 464-4354.

Contact Information

Primary practice address
31815 Southfield Rd Ste 24 Beverly Hills MI 48025-5471
Phone: (248) 464-4354
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 4301045596 Michigan
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 4301045596 Michigan
Behavioral Health & Social Service Providers / Psychoanalysis 103TP0814X

Profile Details

NPI number 1699734012
LBN Legal business name Koltonow, Sanford
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 23rd, 2006
Last updated Jun 14th, 2023 - about 3 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 1699734012 NPPES
Michigan Other 010F362410 BCBSM
Michigan MEDICAID 1577750 BCBSM

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