Organization
LUANA J KYSELKA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUANA J KYSELKA MD (PRESIDENT)
(248) 643-6634
Entity
Organization
Contact information
Practice address
2877 CROOKS ROAD, SUITE D, TROY, MI 48084-4717
(248) 643-6634
(248) 643-7165
Mailing address
2877 CROOKS RD, SUITE D, TROY, MI 48084-4717
(248) 643-6634
(248) 643-7165
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
LK043787
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0630809
BCBSM
MI
Enumeration date
04/29/2008
Last updated
02/14/2011
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