person
Dr. Bruce Ian Kaczander, DPM
Foot & Ankle Surgery Podiatrist in Southfield, Michigan
NPI 1518963628

Bruce Ian Kaczander is a Foot & Ankle Surgery Podiatrist based in Southfield, MI and is specialized in Foot & Ankle Surgery. Bruce Ian Kaczander practices in Southfield, MI and has the professional credentials of DPM. The NPI Number for Bruce Ian Kaczander is 1518963628 and holds a License No. BK001054 (Michigan).

The current practice location address for Bruce Ian Kaczander is 24725 W 12 Mile Rd, Southfield, MI and can be reached out via phone at 248-353-9300 and via fax at 248-353-9303. You can also correspond with Bruce Ian Kaczander through the mailing address at 24725 W 12 MILE RD, SOUTHFIELD, MI - 48034-8310 (mailing address contact number: 248-353-9300).

Location: 24725 W 12 Mile Rd, Southfield, MI, 48034-8310
person
Provider Profile Details
NPI Number
1518963628
Provider Name
Bruce Ian Kaczander
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
24725 W 12 Mile Rd, Southfield, MI, 48034-8310
Phone Number
248-353-9300
Fax Number
248-353-9303
Provider Enumeration Date
06/23/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000002793 01 MI CAPE
480029296 01 MI TRICARE
C6928 01 MI MCARE
4188228 05 MI
503536 01 MI CARE CHOICE
104550400 01 MI US DEP
T34322 01 MI HEALTH ALLIANCE PLAN
101509 01 MI GREAT LAKES
503536 01 MI PREFERRED CHOICES
83291 01 MI OMNI
institution
Provider Business Practice Location Address Details
Address
24725 W 12 Mile Rd
City
State
Zip
48034-8310
Phone Number
248-353-9300
Fax Number
248-353-9303
person
Provider Business Mailing Address Details
Address
24725 W 12 Mile Rd
City
State
Zip
48034-8310
Phone Number
248-353-9300
Fax Number
248-353-9303
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
BK001054 (Michigan)
Definition
Definition to come...
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