| Kenneth Dziuba MD PC | |
|
21331 Kelly Rd Eastpointe MI 48021-3265 | |
| (586) 773-7780 | |
| (586) 774-9656 |
| Full Name | Kenneth Dziuba MD PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 21331 Kelly Rd, Eastpointe, Michigan |
| Authorized Official Name and Position | Kenneth Dziuba (PRESIDENT) |
| Authorized Official Contact | 5867737780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Dziuba MD PC 21331 Kelly Rd Eastpointe MI 48021-3265 Ph: (586) 773-7780 | Kenneth Dziuba MD PC 21331 Kelly Rd Eastpointe MI 48021-3265 Ph: (586) 773-7780 |
| NPI Number | 1891955597 |
|---|---|
| Provider Enumeration Date | 06/16/2008 |
| Last Update Date | 03/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891955597 | NPI | - | NPPES |
| 4157965 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 43010039122 (Michigan) | Primary |
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