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Individual

DR. JACOB KALO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., P.C.

Contact information

Practice address
15650 E 8 MILE RD, DETROIT, MI 48205-1444
(313) 526-3600
(313) 526-3603
Mailing address
28477 HOOVER RD, WARREN, MI 48093-5438
(586) 751-7070
(586) 751-7071

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
4301040053
MI
207VX0000X
Obstetrics Physician
Primary
4301040053
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0500428
BLUE CROSS ID
MI
05
1594887
MI
Enumeration date
02/09/2006
Last updated
11/02/2022
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