Healthcare Provider Details

I. General information

NPI: 1447236328
Provider Name (Legal Business Name): STEVEN A KUSHNER DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3272 E 12 MILE RD. #106 DEERFIELD MEADOWS
WARREN MI
48092-5436
US

IV. Provider business mailing address

3272 E 12 MILE RD. #106 DEERFIELD MEADOWS
WARREN MI
48092-5436
US

V. Phone/Fax

Practice location:
  • Phone: 586-751-3650
  • Fax: 586-751-3505
Mailing address:
  • Phone: 586-751-3650
  • Fax: 586-751-3505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN ALAN KUSHNER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 248-305-9614