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NPI Code Detail

MEDICARE: DR. SHAKTI KAUL M.D.

MEDICARE: DR. SHAKTI KAUL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician4301042095MI

General Provider Information

NPI Number : 1164727525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAKTI KAUL M.D.
Provider Business Mailing Address
First Line : 6480 ISLAND LAKE DR
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-9735
Country : US
Telephone Number : 517-339-2997
Fax Number :
Provider Business Practice Location Address
First Line : 5135 S PENNSYLVANIA AVE
Second Line :
City : LANSING
State : MI
Zip : 48911-4002
Country : US
Telephone Number : 517-887-5922
Fax Number : 517-887-5982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2011
Last Update Date : 01/17/2011

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