Individual
KELLY J WALKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 E MEDICAL CENTER DR, 7TH FLOOR CS MOTT CHILDRENS HOSPITAL, ANN ARBOR, MI 48109-5000
(734) 936-9814
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301091586
MI
208000000X
Pediatrics Physician
MT186623
PA
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
4301091586
MI
Other
Enumeration date
07/23/2007
Last updated
05/01/2013
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