Individual
ANDREI KATYCHEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
29877 TELEGRAPH RD STE 302, SOUTHFIELD, MI 48034
(248) 796-7466
(248) 450-5580
Mailing address
29877 TELEGRAPH RD STE 302, SOUTHFIELD, MI 48034-7660
(248) 796-7466
(248) 450-5580
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301085733
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942400346
—
MI
01
—
4301085733
LICENSE
MI
01
—
4301085733
LICENSE
—
Enumeration date
07/23/2007
Last updated
06/01/2019
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