Healthcare Provider Details

I. General information

NPI: 1336778968
Provider Name (Legal Business Name): KALMUS PODIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 AUTO CLUB DR STE 220
DEARBORN MI
48126-2619
US

IV. Provider business mailing address

5250 AUTO CLUB DR STE 220
DEARBORN MI
48126-2619
US

V. Phone/Fax

Practice location:
  • Phone: 734-287-2500
  • Fax: 734-287-2606
Mailing address:
  • Phone: 734-287-2500
  • Fax: 734-287-2606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLAN L KALMUS
Title or Position: PHYSICIAN/OWNER
Credential:
Phone: 734-287-2500