| 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 |
|---|---|
| Provider Enumeration Date | 06/26/2021 |
| Last Update Date | 06/26/2021 |
| Certification Date | 06/26/2021 |
| Medicare PECOS PAC ID | 2466850284 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790901429 PECOS PAC ID: 5496834871 Enrollment ID: I20080509000585 |
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