1174587380 NPI number — DR. WILLIAM HSU KOLE M.D.

Table of content: MRS. LE-ZHI LIN (NPI 1407929623)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174587380 NPI number — DR. WILLIAM HSU KOLE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOLE
Provider First Name:
WILLIAM
Provider Middle Name:
HSU
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174587380
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43401 SCHOENHERR RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STERLING HEIGHTS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48313-1961
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-488-3636
Provider Business Mailing Address Fax Number:
586-488-3635

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
43401 SCHOENHERR RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STERLING HEIGHTS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48313-1961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-488-3636
Provider Business Practice Location Address Fax Number:
554-445-2800
Provider Enumeration Date:
04/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208VP0014X , with the licence number:  4301056051 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 136275400 . This is a "ACS DEPT OF LABOR" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 050088223 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0E00595 . This is a "BCBSM GROUP NUMBER" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 10 4280270 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0505011422 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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