Provider Demographics
NPI:1659353639
Name:KAHN, JOEL K (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:K
Last Name:KAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4050 W MAPLE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BLOOMFIELD TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3148
Mailing Address - Country:US
Mailing Address - Phone:248-731-7412
Mailing Address - Fax:248-592-7130
Practice Address - Street 1:4050 W MAPLE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:BLOOMFIELD TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48301-3148
Practice Address - Country:US
Practice Address - Phone:248-731-7412
Practice Address - Fax:248-592-7130
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2016-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301047704207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00631GOtherHEALTH ALLIANCE PLAN
MIP00961553OtherRAILROAD MEDICARE
MI00631GOtherHEALTH ALLIANCE PLAN
MIMI3973148Medicare PIN