Kenneth Dalen, | |
44201 Dequindre Rd, Troy, MI 48085-1117 | |
(248) 964-5190 | |
Not Available |
Full Name | Kenneth Dalen |
---|---|
Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 44201 Dequindre Rd, Troy, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851350763 | NPI | - | NPPES |
2833757 | Medicaid | MI | |
300F362420 | Other | MI | BCBSM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 4301052664 (Michigan) | Primary |
Entity Name | Troy Internal Medicine, Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356450589 PECOS PAC ID: 0840282067 Enrollment ID: O20040330001398 |
Mailing Address | Practice Location Address |
---|---|
Kenneth Dalen, 3601 W 13 Mile Rd, 400-fsc/pcs, Royal Oak, MI 48073-6712 Ph: () - | Kenneth Dalen, 44201 Dequindre Rd, Troy, MI 48085-1117 Ph: (248) 964-5190 |
Ming Lin Hsieh, Radiology Medicare: Accepting Medicare Assignments Practice Location: 44201 Dequindre Rd, Troy, MI 48085 Phone: 248-964-5190 | |
Marie Konczalski, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 44201 Dequindre Rd, Beaumont Hospital - Troy, Troy, MI 48085 Phone: 248-964-5190 Fax: 248-964-5199 | |
Brian Berger, Radiology Medicare: Accepting Medicare Assignments Practice Location: 44201 Dequindre Rd, Troy, MI 48085 Phone: 248-964-5190 | |
Tarun Gupta, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 44201 Dequindre Rd, Troy, MI 48085 Phone: 248-964-5000 | |
Robert Warren Mendelson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 2541 Manchester Ct, Troy, MI 48098 Phone: 248-879-8100 Fax: 248-879-8300 | |
Dr. Krisha J Howell, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 4550 Investment Dr Ste B111, Troy, MI 48098 Phone: 248-952-5019 | |
Stephen Zintsmaster, Radiology Medicare: Accepting Medicare Assignments Practice Location: 44201 Dequindre Rd, Troy, MI 48085 Phone: 248-964-5190 Fax: 248-964-5199 |