Basic Information
| Provider Information | |||||||||
| NPI: | 1417157165 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KADAJ | ||||||||
| FirstName: | PHILLIP | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4401 CAMPUS RIDGE DR | ||||||||
| Address2: | STE 1100 | ||||||||
| City: | MIDLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486406112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898379200 | ||||||||
| FaxNumber: | 9898379205 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 CAMPUS RIDGE DR STE 1100 | ||||||||
| Address2: | |||||||||
| City: | MIDLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486406125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898379200 | ||||||||
| FaxNumber: | 9898379205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301090460 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.