Kaczkofsky, Peter Earl David
Kaczkofsky, Peter Earl David is an individual health care provider with primary practice located at 2221 Health Dr Sw , Wyoming MI 49509. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Kaczkofsky, Peter Earl David can be contacted via phone (616) 252-4410.Contact Information
Primary practice address
2221 Health Dr Sw
Wyoming MI 49509
Phone: (616) 252-4410
Fax: (616) 252-4480
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 012006 | Michigan |
Profile Details
| NPI number | 1710089453 |
|---|---|
| LBN Legal business name | Kaczkofsky, Peter Earl David |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 2nd, 2006 |
| Last updated | Dec 8th, 2017 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710089453 | NPPES |
| Michigan | Other | 1654101584 | BLUE CARE NETWORD |
| Michigan | MEDICAID | 4708195 | BLUE CARE NETWORD |
| Michigan | MEDICAID | 4708275 | BLUE CARE NETWORD |
| Michigan | MEDICAID | 4708005 | BLUE CARE NETWORD |
| Michigan | Other | 1654101584 | BLUE CARE NETWORD |
| Michigan | MEDICAID | 4708168 | BLUE CARE NETWORD |
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