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Contact Information

CHARLES G KISSEL DPM PC
29433 RYAN RD
WARREN, MI48092-2203
 Phone: 586-574-0500
 Fax: 586-574-2694
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for CHARLES G KISSEL DPM PC

NPI # 1043498652
LBN Legal business name CHARLES G KISSEL DPM PC
Authorized official CHARLES KISSEL - (PARTNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/06/2008
Last updated 05/16/2008 - About 18 years ago
Identifiers
MI License # CK000960
MI Medicaid 1715614
MI Medicaid 4949617
MI Other 5972192 AETNA
MI Other P44714 B PLUS
MI Other 480E011810 BCBSM
MI Other 480F335300 BCBSM
MI Other 480Q245670 BCBSM
MI Other 2559787 CIGNA
MI Other 5987390001 DME
MI Other 6087740001 DME
MI Other 5137446 FIRST HEALTH
MI Other 12268 M-CARE
MI Other 480017380 MCRR
MI Other 480017711 MCRR
MI Other P00422721 MCRR
MI Other 21171 OMNI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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