MEDICARE: DR. KEVIN ALEXANDER BRODY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	4301061861	MI
2	207P00000X	Emergency Medicine Physician	0101244238	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	11272666	OTHER	CAQH
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	0108236832	OTHER	BCBS PIN
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	KB061861	OTHER	BCBS

General Provider Information

NPI Number	:	1063490621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN ALEXANDER BRODY MD

Provider Business Mailing Address
First Line	:	38935 ANN ARBOR ROAD
Second Line	:	CREDENTIALING/PAYER CONTRACTING SERVICES
City	:	LIVONIA
State	:	MI
Zip	:	48150-3397
Country	:	US
Telephone Number	:	734-632-0175
Fax Number	:	734-632-0182

Provider Business Practice Location Address
First Line	:	15855 19 MILE ROAD
Second Line	:	EMERGENCY MEDICINE DEPARTMENT
City	:	CLINTON TWP
State	:	MI
Zip	:	48038-3504
Country	:	US
Telephone Number	:	586-236-2601
Fax Number	:	586-263-2589

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	10/16/2014

Similar Medicare Providers

1457892879 — MICHAEL MCDONALD DO
Practice Location Address:

15855 19 MILE RD
CLINTON TWP, MI
48038-3504

Practice Phone: 586-263-2973
Practice Fax:

1811991177 — DR. TIMOTHY PETER BOUFFORD M.D.
Practice Location Address:

15855 19 MILE RD , HENRY FORD MACOMB
CLINTON TWP, MI
48038-3504

Practice Phone: 734-464-0887
Practice Fax: 734-402-0254

1720066319 — ROBILYN ANN COLLINS NP
Practice Location Address:

15855 NINETEEN MILE ROAD , EMERGENCY MEDICINE DEPARTMENT
CLINTON TWP, MI
48038-3504

Practice Phone: 586-263-2601
Practice Fax: 586-263-2589

1639157209 — DR. AMIT CHOPRA DO
Practice Location Address:

15855 NINETEEN MILE ROAD , EMERGENCY MEDICINE DEPARTMENT
CLINTON TWP, MI
48038-3504

Practice Phone: 586-263-2601
Practice Fax: 586-263-2589

1487632923 — DENISE DYAR NP
Practice Location Address:

15855 19 MILE RD
CLINTON TWP, MI
48038-3504

Practice Phone: 586-236-2601
Practice Fax: 586-263-2589

1932187192 — DR. PATRICIA L. MILANI M.D.
Practice Location Address:

15855 19 MILE RD
CLINTON TWP, MI
48038-3504

Practice Phone: 586-236-2601
Practice Fax: 866-250-6385

Directions to “ DR. KEVIN ALEXANDER BRODY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.