Individual
JESSICA MARIE KANIOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Mailing address
118 S GEORGETOWN SQ, ROYAL OAK, MI 48067-3204
(248) 543-6559
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301090461
MI
Other
Enumeration date
06/14/2007
Last updated
07/08/2007
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