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:
Health care specialties
Specialty | Code | License # | 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 last year |
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 | 1699734012 | NPPES |
Michigan | Other | 010F362410 | BCBSM |
Michigan | MEDICAID | 1577750 | BCBSM |
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