Healthcare Provider Details

I. General information

NPI: 1760988620
Provider Name (Legal Business Name): KYLE CASADEI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2018
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 CROSS CREEK PKWY STE 200
AUBURN HILLS MI
48326-2776
US

IV. Provider business mailing address

15855 19 MILE RD
CLINTON TOWNSHIP MI
48038-3504
US

V. Phone/Fax

Practice location:
  • Phone: 248-377-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number5101025161
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: