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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
BK001054 | MI | Podiatric Medicine & Surgery Service Providers |
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 |
Street Address |
24725 W 12 MILE RD STE 270 |
City | SOUTHFIELD |
State | MI |
Zip Code | 48034-8310 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 48034 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
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 |
Find all providers in SOUTHFIELD |
City | SOUTHFIELD |
Zip Code | 48034 |
Please comment or provide details below to improve the information on DR. BRUCE IAN KACZANDER.
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.