Organization
MICHIGAN INFECTIOUS DISEASE CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAMLA A KALYAN MD (OWNER)
(248) 212-0678
Entity
Organization
Contact information
Practice address
44200 WOODWARD AVE, SUITE 101, PONTIAC, MI 48341-5046
(248) 212-0678
(248) 212-0790
Mailing address
4920 ADAMS POINTE CT, TROY, MI 48098-4111
(248) 212-0678
(248) 212-0790
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106366471
BCN
MI
05
—
1699934554
—
MI
01
—
440F306450
BCS
MI
05
—
4717980
—
MI
Enumeration date
06/05/2008
Last updated
09/26/2014
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