1750555827 NPI number — BRUCE L. KAPLAN DO, PC

Table of content: (NPI 1750555827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750555827 NPI number — BRUCE L. KAPLAN DO, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRUCE L. KAPLAN DO, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1750555827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22250 PROVIDENCE DRIVE
Provider Second Line Business Mailing Address:
SUITE #200
Provider Business Mailing Address City Name:
SOUTHFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48075-6210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-552-0242
Provider Business Mailing Address Fax Number:
248-552-8418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22250 PROVIDENCE DRIVE
Provider Second Line Business Practice Location Address:
SUITE #200
Provider Business Practice Location Address City Name:
SOUTHFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48075-6210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-552-0242
Provider Business Practice Location Address Fax Number:
248-552-8418
Provider Enumeration Date:
04/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KAPLAN
Authorized Official First Name:
BRUCE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
248-552-0242

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  BK006986 , 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: 1156306265 . This is a "BLUE CROSS BLUE SHIELD MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com