Organization
ONLINE CONTROLLED KRAVINGS WEIGHT LOSS PLLC
Active
Parent organization
ONLINE CONTROLLED KRAVINGS WEIGHT LOSS PLLC
Other names
Chronic Disease and Health Management
Organization subpart
Yes
Provider details
NPI number
Legal business name
ONLINE CONTROLLED KRAVINGS WEIGHT LOSS PLLC
Authorized official
ZAKARI TATA MD (AUTHORIZED OFFICIAL)
(248) 429-9556
Entity
Organization
Contact information
Practice address
21701 W 11 MILE RD STE 5, SOUTHFIELD, MI 48076-3713
(248) 429-9556
Mailing address
21701 W 11 MILE RD STE 5, SOUTHFIELD, MI 48076-3713
(248) 429-9556
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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