Healthcare Provider Details

I. General information

NPI: 1497924971
Provider Name (Legal Business Name): K. KUMARI-LOBO, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24353 ORCHARD LAKE RD SUITE E
FARMINGTON HILLS MI
48336-1917
US

IV. Provider business mailing address

24353 ORCHARD LAKE RD SUITE E
FARMINGTON HILLS MI
48336-1917
US

V. Phone/Fax

Practice location:
  • Phone: 248-477-1610
  • Fax: 248-477-1613
Mailing address:
  • Phone: 248-477-1610
  • Fax: 248-477-1613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberKK034366
License Number StateMI

VIII. Authorized Official

Name: DR. K KUMARI-LOBO
Title or Position: OWNER
Credential: M.D.
Phone: 248-477-1610