Healthcare Provider Details

I. General information

NPI: 1558152660
Provider Name (Legal Business Name): ALEDADE TK MI, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 COURT ST S
STANDISH MI
48658-9415
US

IV. Provider business mailing address

4550 MONTGOMERY AVE STE 950N
BETHESDA MD
20814-3339
US

V. Phone/Fax

Practice location:
  • Phone: 989-394-7118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT P KOCHER
Title or Position: OWNER
Credential: MD
Phone: 650-475-3710