Individual
DR. KIM FORD KEZLARIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26300 WOODWARD AVE, ROYAL OAK, MI 48067-0917
(245) 546-2110
(248) 546-8176
Mailing address
26300 WOODWARD AVE, ROYAL OAK, MI 48067-0917
(245) 546-2110
(248) 546-8176
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301041887
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F32365
BCBS
MI
05
—
104860996
—
MI
Enumeration date
11/02/2006
Last updated
10/15/2012
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