Organization
KS MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIANOUSH SHEYKHOLESLAMI M.D. (PRESIDENT)
(330) 289-9891
Entity
Organization
Contact information
Practice address
ONE ROBERT WOOD JOHNSON PLACE, ROBERT WOOD JOHNSON HOSPITAL, NEW BRUNSWICK, NJ 08901-1966
(330) 289-9891
Mailing address
5118 SILVER FOX TRL, ROCKFORD, IL 61114-7010
(330) 289-9891
Taxonomy
Speciality
Code
Description
License number
State
207YS0012X
Sleep Medicine (Otolaryngology) Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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