Provider Demographics
NPI:1750323432
Name:KACHMAN, ALICE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:MARIE
Last Name:KACHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:15400 W MCNICHOLS RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3724
Mailing Address - Country:US
Mailing Address - Phone:313-416-6262
Mailing Address - Fax:855-643-6164
Practice Address - Street 1:15400 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3724
Practice Address - Country:US
Practice Address - Phone:313-416-6262
Practice Address - Fax:855-643-6164
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301070137207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP01003972OtherMEDICARE RAILROAD
MI0H11747OtherBCBS
MI4219146Medicaid
MI4219146Medicaid