Organization
JACOB KALO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB KALO M.D. (OWNER)
(313) 526-3600
Entity
Organization
Contact information
Practice address
15650 E 8 MILE RD, DETROIT, MI 48205-1444
(313) 526-3600
(313) 526-3603
Mailing address
15650 E 8 MILE RD, DETROIT, MI 48205-1444
(313) 526-3600
(313) 526-3603
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
JK040053
MI
207V00000X
Obstetrics & Gynecology Physician
—
—
207VX0000X
Obstetrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1703687
—
MI
01
—
7820007
BLUE CROSS PIN
MI
Enumeration date
06/21/2007
Last updated
11/02/2022
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