Individual
MATTHEW DANIEL KUKAWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-0535
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1863
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601012018
MI
Other
Enumeration date
09/11/2023
Last updated
10/06/2023
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