Individual
MANISH N KESLIKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27211 LAHSER ROAD, STE #200, SOUTHFIELD, MI 48034-4147
(248) 358-4892
(248) 358-5125
Mailing address
28411 NORTHWESTERN HWY, STE # 1050, SOUTHFIELD, MI 48034-0047
(248) 354-4709
(248) 354-4807
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301080609
MI
207R00000X
Internal Medicine Physician
MK080609
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104854219
—
MI
01
—
11-0F33636-0
BCBSM GRP PIN
MI
01
—
1346398971
CORPORTATE NPI
MI
01
—
20-5485614
TAX ID
MI
01
—
MK080609
STATE LICENSE
MI
Enumeration date
05/16/2006
Last updated
02/28/2014
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