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General NPI Number Information
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NPI Number | 1619339918
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Entity Type | Organization
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Legal Business Name | REZA KAHNAMOUEI MD PLLC
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Dates
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Enumeration Date | 03/25/2016
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 43361 COMMONS DR
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1109
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Country | US
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Telephone | 586-745-3006
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Fax |
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Provider Business Mailing Address
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Address Line | 43361 COMMONS DR
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1109
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Country | US
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Telephone | 586-745-3006
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. EMILIE MARIE PINEAU
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Credential |
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Telephone | 586-745-3006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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