Kristian Michael Koller D.O.

NPI 1760793368 - Internal Medicine - 207R00000X

NPI Details
NPI 1760793368
Gender Male
Enumeration Date 06/29/2010
Last Updated 06/29/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
5900 BYRON CENTER AVE SW
ATTN: MEDICAL EDUCATION
WYOMING MI, 49519-9606, US
Phone (616) 252-7419
Fax
Business Location
3969 WEDGEWOOD DR SW
WYOMING MI, 49519-3137, US
Phone (586) 996-3385
Fax
Toxanomy
Taxonomy Code 207R00000X
License State Michigan
License Number 5101018711
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According to our database, Kristian Michael Koller D.O. NPI is 1760793368, taxonomy code is 207R00000X and license number is 5101018711, license state is located at Michigan. Kristian Michael Koller D.O. physically located at 5900 Byron Center Ave Sw, Wyoming MI, 49519-9606. NPI Number Kristian Michael Koller D.O. has the Individual type.

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1760793368 NPI number is provided on an as is basis without warranty of any kind. 1760793368 is maintained by the National Plan & Provider Enumeration System. The contents of Kristian Michael Koller D.O. are for informational purposes only.