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General NPI Number Information
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NPI Number | 1457407074
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Entity Type | Individual
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Provider Name | TADD KAEO HIATT MD
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Gender | Male
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 1650 RAMBLEWOOD DR STE 300
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City | EAST LANSING
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State | MI
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Zip | 48823-7396
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Country | US
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Telephone | 517-332-1200
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Fax | 517-351-7122
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Provider Business Mailing Address
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Address Line | 1701 SOUTH BLVD E STE 300
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-6120
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Country | US
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Telephone | 248-884-9710
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Fax | 248-884-9711
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301100152
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 46668
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301100152
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License Number State | MI
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