Individual
DR. AYDIN TAVAKOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MSC, BSC
Contact information
Practice address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
(269) 337-4400
Mailing address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
(269) 337-4400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
XXX
MI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
1073929600
MI
Other
Enumeration date
07/03/2014
Last updated
06/15/2015
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