Kai Anderson, M.d., Pllc | |
26520 Grand River Ave Ste 128 Redford MI 48240-1506 | |
(313) 533-5652 | |
(313) 533-5644 |
Full Name | Kai Anderson, M.d., Pllc |
---|---|
Speciality | Clinic/Center |
Location | 26520 Grand River Ave Ste 128, Redford, Michigan |
Authorized Official Name and Position | Kai Anderson (OWNER) |
Authorized Official Contact | 3132827968 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Kai Anderson, M.d., Pllc 5112 Old Barn Ln Clio MI 48420-8279 Ph: (313) 282-7968 | Kai Anderson, M.d., Pllc 26520 Grand River Ave Ste 128 Redford MI 48240-1506 Ph: (313) 533-5652 |
NPI Number | 1396315099 |
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Provider Enumeration Date | 06/26/2021 |
Last Update Date | 06/26/2021 |
Certification Date | 06/26/2021 |
Medicare PECOS PAC ID | 2466850284 |
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Medicare Enrollment ID | O20211008001843 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396315099 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
Provider Name | Kai Anderson |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1790901429 PECOS PAC ID: 5496834871 Enrollment ID: I20080509000585 |
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