Provider Demographics
NPI:1225011554
Name:KALT, STEVEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:KALT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4600 INVESTMENT DR
Mailing Address - Street 2:STE 300
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-6368
Mailing Address - Country:US
Mailing Address - Phone:248-267-5000
Mailing Address - Fax:248-267-5001
Practice Address - Street 1:2010 16TH ST STE C
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5188
Practice Address - Country:US
Practice Address - Phone:970-392-2026
Practice Address - Fax:970-392-2027
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301073389207R00000X
CODR-49443207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO35104872Medicaid
CO35104872Medicaid
OM55750Medicare ID - Type Unspecified
COCOA104787Medicare PIN