MEDICARE: DR. YAEL DUER KOLOFF DO

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
1	207RP1001X	Pulmonary Disease Physician	5101028603	MI

General Provider Information

NPI Number	:	1215594775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YAEL DUER KOLOFF DO

Provider Business Mailing Address
First Line	:	12000 E 12 MILE RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48093-3570
Country	:	US
Telephone Number	:	248-770-5877
Fax Number	:

Provider Business Practice Location Address
First Line	:	1950 E WATTLES RD STE 101
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48085-5099
Country	:	US
Telephone Number	:	248-238-8374
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2019
Last Update Date	:	12/21/2025

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