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General NPI Number Information
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NPI Number | 1699262006
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Entity Type | Organization
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Legal Business Name | AFFILIATED KNEE PAIN SPECIALISTS, PLLC
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 31333 SOUTHFIELD RD STE 103
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-5473
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Country | US
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Telephone | 248-952-9190
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Fax | 248-952-9190
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Provider Business Mailing Address
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Address Line | 45445 MOUND RD STE 105
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48317-5178
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Country | US
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Telephone | 866-207-5105
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Fax |
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Authorized Official
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Title or Position | OWNER/MEDICAL DOCTOR
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Name | STEVE Z. KALLABAT
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Credential | MD
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Telephone | 928-445-7085
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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 | 4301070138
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License Number State | MI
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