Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | TK008913 | MI |
N | 207Q00000X | Family Doctor | TK008913 | MI |
NPI | 1447268644 |
---|---|
Provider Name | Dr. Thomas Reid Kavieff |
First Address | West Bloomfield, MI 48323-2184 |
Second Address | West Bloomfield, MI 48323-2184 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B40992 | (02) | MI |