Individual
DR. KEVIN FANTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
26711 NORTHWESTERN HIGHWAY, SUITE 400, SOUTHFIELD, MI 48033-2154
(248) 948-9900
Mailing address
26711 NORTHWESTERN HIGHWAY, SUITE 400, SOUTHFIELD, MI 48033-2154
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302035536
MI
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PS48603
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302035536
MI CONTROLLED SUBSTANCE LICENSE
MI
01
—
PS48603
FL CONTROLLED SUBSTANCE LICENSE
FL
Enumeration date
05/03/2008
Last updated
08/27/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us