Provider Demographics
NPI:1700820354
Name:KASTEN, MICHAEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:KASTEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M206A
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-488-8355
Mailing Address - Fax:269-488-8356
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE M-206A
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-488-8355
Practice Address - Fax:269-488-8356
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301062050207XS0117X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1700820354Medicaid
MI2003910152OtherBCBS PIN
MI4492405-10Medicaid
4276342OtherAETNA PIN
155409OtherGREAT LAKES HLTH PLAN
MI4492405-10Medicaid
4276342OtherAETNA PIN
F33654Medicare UPIN
MI0C97625082Medicare ID - Type Unspecified
MIC97618259Medicare PIN
155409OtherGREAT LAKES HLTH PLAN