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Organization

ZACHARY KANJUPARAMBAN MDPC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER MCCONKIE (OFFICE MANAGER)
(989) 772-1989
Entity
Organization

Contact information

Practice address
211 S CRAPO ST, SUITE D, MT PLEASANT, MI 48858-2961
(989) 772-1989
(989) 772-5523
Mailing address
211 S CRAPO ST, SUITE D, MT PLEASANT, MI 48858-2961
(989) 772-1989
(989) 772-5523

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301033831
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1425759
MI
Enumeration date
09/02/2009
Last updated
09/02/2009
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