Provider Demographics
NPI:1740864156
Name:LAW, KAI NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:KAI
Middle Name:NICOLE
Last Name:LAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAI
Other - Middle Name:NICOLE
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4201 ST. ANTOINE
Mailing Address - Street 2:UHC-9C
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:818-633-9518
Mailing Address - Fax:
Practice Address - Street 1:4201 ST. ANTOINE
Practice Address - Street 2:UHC-9C
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:818-633-9518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program