Doctor Name: | NECOLE MARIE KOLIBA |
NPI Number: | 1346560281 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DO |
License Number: | 5101018603 |
Business Practice Address: | 601 John St Suite #352 Kalamazoo, MI - 490075341 |
Business Phone Number: | 2693418986 |
Business Fax Number: | 2693416236 |
Mailing Address: | 601 John St, Suite E3552 KALAMAZOO |
State: | MI |
Postal Code: | 490075341 |
Phone Number: | 2693418686 |
Fax Number: | 2693416236 |
NPI Enumeration Date: | 06/02/2010 |
NPI Last Update Date: | 10/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 5101018603 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |