Organization
MARVIN L KOFENDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN L KOFENDER MD (PRESIDENT)
(248) 539-9084
Entity
Organization
Contact information
Practice address
6900 ORCHARD LAKE RD, SUITE 207, WEST BLOOMFIELD, MI 48322-3405
(248) 539-9084
(248) 539-9088
Mailing address
6900 ORCHARD LAKE RD, SUITE 207, WEST BLOOMFIELD, MI 48322-3405
(248) 539-9084
(248) 539-9088
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MK027675
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C1649
MCARE
MI
01
—
P118047
CARE CHOICES
MI
Enumeration date
03/26/2007
Last updated
08/22/2020
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