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Individual

KEVIN ANH TAI VAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16815 E JEFFERSON AVE STE 120, GROSSE POINTE, MI 48230-1923
(586) 498-4400
Mailing address
414 W ROBERT AVE, HAZEL PARK, MI 48030-3223
(303) 475-6054

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4351054412
MI

Other

Enumeration date
06/04/2025
Last updated
06/04/2025
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