Provider Demographics
NPI:1518932573
Name:SCHLABACH, KIM D (DO)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:D
Last Name:SCHLABACH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:595 BARCLAY CIRCLE
Mailing Address - Street 2:SUITE D
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-852-5355
Mailing Address - Fax:248-852-8411
Practice Address - Street 1:595 BARCLAY CIRCLE
Practice Address - Street 2:SUITE D
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-852-5355
Practice Address - Fax:248-852-8411
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2012-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101009662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N33640OtherBCBS
0N33640Medicare ID - Type Unspecified
H00457Medicare UPIN