Individual
PHOENIX KHALID MAIKOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 LAMONT AVE, KALAMAZOO, MI 49048-4156
(269) 385-6128
Mailing address
4288 ESCAPE DR APT 102C, KALAMAZOO, MI 49006-6761
(269) 615-0494
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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