Provider Demographics
NPI:1558435628
Name:KALE, NAMDEO (MD)
Entity Type:Individual
Prefix:
First Name:NAMDEO
Middle Name:
Last Name:KALE
Suffix:
Gender:M
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:PO BOX 7104
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48311-7104
Mailing Address - Country:US
Mailing Address - Phone:248-338-0860
Mailing Address - Fax:248-338-6013
Practice Address - Street 1:35 S JOHNSON ST
Practice Address - Street 2:STE 2 D
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-1658
Practice Address - Country:US
Practice Address - Phone:248-338-0860
Practice Address - Fax:248-338-6013
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2013-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5315021400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I47892Medicare UPIN