Organization
KIM M ALMODOVAR MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM M ALMODOVAR M.D. (OWNER)
(248) 656-4225
Entity
Organization
Contact information
Practice address
1460 WALTON BLVD, SUITE 209, ROCHESTER HILLS, MI 48309-1768
(248) 656-4225
(248) 656-4250
Mailing address
1460 WALTON BLVD, SUITE 209, ROCHESTER HILLS, MI 48309-1768
(248) 656-4225
(248) 656-4250
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
053408
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0M96440
MEDICARE PTAN
MI
01
—
0M96440
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER
—
05
—
4177912
—
MI
Enumeration date
03/05/2007
Last updated
11/28/2023
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