# ONLINE CONTROLLED KRAVINGS WEIGHT LOSS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ONLINE CONTROLLED KRAVINGS WEIGHT LOSS PLLC
- **Other names:** Chronic Disease and Health Management
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043096761
- **Legal business name:** ONLINE CONTROLLED KRAVINGS WEIGHT LOSS PLLC
- **Authorized official:** ZAKARI TATA MD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (248) 429-9556

## Contact information

- **Practice address:** 21701 W 11 MILE RD STE 5, SOUTHFIELD, MI 48076-3713
- **Practice address phone:** (248) 429-9556
- **Mailing address:** 21701 W 11 MILE RD STE 5, SOUTHFIELD, MI 48076-3713
- **Mailing address phone:** (248) 429-9556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 09/07/2023
- **Last updated:** 09/07/2023