Individual
DR. MICHAEL S KOBERNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5052
Mailing address
25424 HENLEY AVE, HUNTINGTON WOODS, MI 48070-1709
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301041539
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1925040
—
MI
Enumeration date
07/10/2006
Last updated
11/11/2008
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