DR. BRUCE IAN KACZANDER


Address: 24725 W 12 Mile Rd, Ste 270, Southfield, MI 48034-8310
Phone: 2483539300

DR. BRUCE IAN KACZANDER (NPI# 1518963628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518963628
Entity Type Individual
Full Name DR. BRUCE IAN KACZANDER
Credential DPM
Practice Address 24725 W 12 Mile Rd
Ste 270
Southfield
MI 48034-8310
Practice Telephone 2483539300
Practice Fax Number 2483539303
Mailing Telephone 2483539300
Mailing Fax Number 2483539303
Enumeration Date 2005-06-23
Last Update Date 2012-08-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213ES0103X Podiatrist
Specialization: Foot & Ankle Surgery
BK001054 MI Podiatric Medicine & Surgery Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI TRICARE 480029296 01
MI CARE CHOICE 503536 01
MI MCARE C6928 01
MI CAPE 000000002793 01
MI PREFERRED CHOICES 503536 01
MI GREAT LAKES 101509 01
MI HEALTH ALLIANCE PLAN T34322 01
MI 4188228 05
MI OMNI 83291 01
MI US DEP 104550400 01

Office Location

Street Address 24725 W 12 MILE RD
STE 270
City SOUTHFIELD
State MI
Zip Code 48034-8310

Providers in the same location

NPI Name Taxonomy Address Enumeration
1992128144 Christopher Eaglen Chiropractor 24725 W 12 Mile Rd, Suite 260, Southfield, MI 48034-1801 2014-01-23
1992127104 Family Embrace Home Health Agency Case Management 24725 W 12 Mile Rd, Ste 120, Southfield, MI 48034-1801 2014-01-08
1073934329 Diquita Karva Registered Nurse 24725 W 12 Mile Rd, Ste 120, Southfield, MI 48034-1801 2014-01-03
1548566078 Chiropractors Rehabilitation Group Chiropractor 24725 W 12 Mile Rd, Suite 260, Southfield, MI 48034-1801 2011-02-01
1548595598 Lolita Maria Maliskey Physical Therapist 24725 W 12 Mile Rd, Suite 302, Southfield, MI 48034-1801 2009-10-08
1649460536 Richard J Ruffini Dc PC Chiropractor 24725 W 12 Mile Rd, 260, Southfield, MI 48034-1801 2007-07-27
1023117769 Michael J. Freedman, Md, P.C. Psychiatry & Neurology 24725 W 12 Mile Rd, Suite 310, Southfield, MI 48034-1801 2006-09-21
1760402028 Shelby Ross Glazer Chiropractor 24725 W 12 Mile Rd, Suite 260, Southfield, MI 48034-1801 2006-07-20
1134149404 Richard James Ruffini Chiropractor 24725 W 12 Mile Rd, Suite 260, Southfield, MI 48034-1801 2006-07-20
1265458814 Michigan Foot and Ankle Center P.C. Podiatrist 24725 W 12 Mile Rd, Suite 270, Southfield, MI 48034-1801 2006-07-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780219196 I. R. Horn & Associates LLC Community/Behavioral Health 29623 Norhtwestern Hwy Suite 5, Southfield, MI 48034 2020-03-05
1003378753 Alexis Shivers Physical Therapy Assistant 27500 Lahser Rd, Southfield, MI 48034 2019-04-02
1598257768 El-abbadi Pediatric Clinic Pediatrics 24676 Lahser Road, Southfield, MI 48034 2018-06-04
1689166894 Recore Rehabilitation Services Clinic/Center 25899 W 12 Mile Rd # 340, Southfield, MI 48034 2018-06-04
1578063749 El-abbadi Healthcare Center Clinic/Center 27403 Lahser Rd, Southfield, MI 48034 2018-02-14
1063924819 Diagnostic Hematology, PC Clinical Medical Laboratory 24725 W. Twelve Mile Road, Suite 118, Southfield, MI 48034 2017-11-02
1962929125 Toms Holistic Home Visits Pllc Clinic/Center 28675 Franklin Rd, Suite 217, Southfield, MI 48034 2017-08-28
1265956940 Abbadi Healthcare Pharmacy 27402 Lahser Road, Southfield, MI 48034 2017-08-03
1720517113 Theramedic Home Health Care LLC Home Health 26400 W. 12 Mile Rd, Suite 80, Southfield, MI 48034 2017-06-08
1538695804 Adrienne Rutherford Occupational Therapist 25999 Franklin Pointe Dr, Southfield, MI 48034 2017-05-05
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Taxonomy Information

Taxonomy Code 213ES0103X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Foot & Ankle Surgery

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1790300978 Bhavik Patel Podiatrist 16001 W 9 Mile Rd Fl 2, Southfield, MI 48075-4818 2020-06-12
1538249982 Nsima Usen Dpm, Mph, P.c Podiatrist 27177 Lahser Rd Ste 200, Southfield, MI 48034-8468 2006-10-17
1679510937 Nsima Usen Dpm, Mph, PC Podiatrist 20903 Greenfield Road, Suite 503, Southfield, MI 48075 2006-06-02
1467428045 Guy Richard Pupp Podiatrist 22250 Providence Dr Ste 100, Southfield, MI 48075-6209 2006-02-24
1629631965 Rachelle Lynn Leveille Podiatrist 16001 W. 9 Mile Road, 2nd Floor Depaul, Southfield, MI 48075-4818 2019-04-22
1083160329 Rashonda Jones Podiatrist 16001 W 9 Mile Rd, Southfield, MI 48075-4818 2016-08-28
1255708574 Dr. Tameka Parham Taylor, Pllc Podiatrist 29425 Northwestern Hwy Ste 125, Southfield, MI 48034-1083 2015-08-24
1144604463 Vangjo Cobani Podiatrist 16001 W 9 Mile Rd, Southfield, MI 48075-4818 2015-07-16
1598149379 Ahmad Talal Elhaouli Podiatrist 16001 W 9 Mile Rd, Southfield, MI 48075-4818 2015-07-12
1386022499 Mohomad Al Sawah Podiatrist 16001 W 9 Mile Rd, Southfield, MI 48075-4818 2015-05-08
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Competitor

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City SOUTHFIELD
Zip Code 48034

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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