Organization
DANIEL E KISLOV, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL E KISLOV MD (OWNER)
(231) 727-5565
Entity
Organization
Contact information
Practice address
1675 LEAHY ST, SUITE 328, MUSKEGON, MI 49442-5500
(231) 727-5565
(231) 727-5568
Mailing address
1675 LEAHY ST, SUITE 328, MUSKEGON, MI 49442-5500
(231) 727-5565
(231) 727-5568
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1697919
—
MI
01
—
2406108272
BSBCM
MI
Enumeration date
02/19/2008
Last updated
02/19/2008
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