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Organization
CHARLES G KISSEL DPM PC
Active
Organization
CHARLES G KISSEL DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY SMITH (MANAGER)
(586) 574-0500
Entity
Organization
Contact information
Practice address
29433 RYAN RD, WARREN, MI 48092-2203
(586) 574-0500
(586) 574-2694
Mailing address
29433 RYAN RD, WARREN, MI 48092-2203
(586) 574-0500
(586) 574-2694
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
CK000960
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
MS00843
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
ZH002007
MI
332B00000X
Durable Medical Equipment & Medical Supplies
CK000960
MI
Other
Enumeration date
10/03/2006
Last updated
08/02/2012
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