Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 10978 | MI |
NPI | 1013077494 |
---|---|
Provider Name | Dr. Richard Kulbersh |
First Address | Sterling Hts, MI 48310-4102 |
Second Address | Sterling Hts, MI 48310-4102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/07/2007 |