Provider Demographics
NPI:1508817909
Name:KALINOWSKI, NANCY JEAN (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JEAN
Last Name:KALINOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M515
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-7145
Mailing Address - Fax:269-341-7148
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE M515
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-7145
Practice Address - Fax:269-341-7148
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301406813208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2836122Medicaid
MI0203908222OtherBCBSM
MI1508817909Medicaid
MI1417961137OtherBCBSM - BRONSON
MI2836122Medicaid
MIF27391Medicare UPIN
MI0203908222OtherBCBSM
MIC97618338 BRONSONMedicare PIN