Organization
CENTER FOR EAR,NOSE AND THROAT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN JOE KIN DO (OWNER/PHYSICIAN)
(248) 668-1104
Entity
Organization
Contact information
Practice address
2300 HAGGERTY ROAD, SUITE 2130, WEST BLOOMFIELD, MI 48323
(248) 668-1104
(248) 668-1096
Mailing address
2300 HAGGERTY RD STE 2130, WEST BLOOMFIELD, MI 48323-2191
(248) 668-1104
(248) 668-1096
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
5101010029
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040015528
RAILROAD MEDICARE
MI
01
—
040F338670
BCN
MI
01
—
0456336254
BCBC BCN
MI
01
—
1009579
GREAT WEST
MI
01
—
101058
GREAT LAKES
MI
01
—
107796
CARE CHOICES
MI
01
—
12043
DMC
MI
01
—
2886
CAPE
MI
05
—
4100372
—
MI
01
—
4233036
AETNA
MI
01
—
82908
PHCS
MI
01
—
B9900
MCARE
MI
01
—
F31235
HAP
MI
Enumeration date
06/17/2006
Last updated
02/06/2019
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