Healthcare Provider Details

I. General information

NPI: 1215594775
Provider Name (Legal Business Name): YAEL DUER KOLOFF DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 E WATTLES RD STE 101
TROY MI
48085-5099
US

IV. Provider business mailing address

12000 E 12 MILE RD
WARREN MI
48093-3570
US

V. Phone/Fax

Practice location:
  • Phone: 248-238-8374
  • Fax:
Mailing address:
  • Phone: 248-770-5877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number5101028603
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: