Kaczander, Bruce Ian

Kaczander, Bruce Ian is an individual health care provider with primary practice located at 24725 W 12 Mile Rd Ste 270, Southfield MI 48034-8310. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Kaczander, Bruce Ian can be contacted via phone (248) 353-9300.

Contact Information

Primary practice address
24725 W 12 Mile Rd Ste 270 Southfield MI 48034-8310
Phone: (248) 353-9300
Fax: (248) 353-9303
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X BK001054 Michigan

Profile Details

NPI number 1518963628
LBN Legal business name Kaczander, Bruce Ian
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Aug 8th, 2012 - about 13 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 1518963628 NPPES
Michigan Other 000000002793 CAPE
Michigan Other 480029296 CAPE
Michigan Other C6928 CAPE
Michigan MEDICAID 4188228 CAPE
Michigan Other 503536 CAPE
Michigan Other 104550400 CAPE
Michigan Other T34322 CAPE
Michigan Other 101509 CAPE
Michigan Other 503536 CAPE
Michigan Other 83291 CAPE

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