Provider Demographics
NPI:1659360212
Name:KALMUS, ALLAN L (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:L
Last Name:KALMUS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22908 WICK RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3589
Mailing Address - Country:US
Mailing Address - Phone:734-287-2500
Mailing Address - Fax:734-287-2606
Practice Address - Street 1:22908 WICK RD
Practice Address - Street 2:SUITE C
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3589
Practice Address - Country:US
Practice Address - Phone:734-287-2500
Practice Address - Fax:734-287-2606
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI590001083213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI48-58201410OtherBCBSM
MI48-58218290OtherBCBSM
MI4885977Medicaid
MI0H24108OtherBCBSM
MIP00643851OtherRAILROAD MEDICARE
MI0B51113OtherBCBSM
MI1791652Medicaid
MI1831348416Medicaid
MI0H24108OtherBCBSM
MI1791652Medicaid
MI48-58201410OtherBCBSM
MI48-58218290OtherBCBSM
MI0M77370Medicare PIN