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General NPI Number Information
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NPI Number | 1740373299
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Entity Type | Individual
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Provider Name | CONRAD ANDREW KAWEL III M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20220 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-1412
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Country | US
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Telephone | 248-471-4600
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Fax | 248-471-4082
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Provider Business Mailing Address
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Address Line | 23345 GLENCREEK DR
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-3038
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Country | US
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Telephone | 248-471-6588
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301050558
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License Number State | MI
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