Individual
DR. BRIAN J KOLENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5799 W MAPLE RD, SUITE 159, WEST BLOOMFIELD, MI 48322-4458
(248) 737-0091
(248) 737-0095
Mailing address
5799 W MAPLE RD, SUITE 159, WEST BLOOMFIELD, MI 48322-4458
(248) 737-0091
(248) 737-0095
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301065408
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06304821
BCBS INDIVIDUAL
MI
01
—
110233802
RR MEDICARE
MI
05
—
1417931015
—
MI
01
—
700H273300
BS OF MICHIGAN
MI
Enumeration date
12/06/2005
Last updated
02/20/2013
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