Individual
DR. KOUROSH BAGHELAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 NILES RD STE 6, SAINT JOSEPH, MI 49085-3268
(269) 408-1660
(269) 408-1665
Mailing address
2500 NILES RD STE 6, SAINT JOSEPH, MI 49085-3268
(269) 408-1660
(269) 408-1665
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
4301084433
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104638715
—
MI
Enumeration date
08/19/2005
Last updated
10/15/2012
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