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Organization
T N KAKISH MD PC
Active
Organization
T N KAKISH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARIQ KAKISH MD (OWNER PHYSICIAN)
(248) 399-5492
Entity
Organization
Contact information
Practice address
32121 WOODWARD AVE, SUITE 204, ROYAL OAK, MI 48073-6237
(248) 399-5492
(248) 399-5792
Mailing address
32121 WOODWARD AVE, SUITE 204, ROYAL OAK, MI 48073-6237
(248) 399-5492
(248) 399-5792
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301067872
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110F338390
BCN GROUP
MI
05
—
1629146493
—
MI
01
—
DG3482
MEDICARE RAILROAD
MI
Enumeration date
12/01/2006
Last updated
08/14/2015
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