| Doctor Name: | VINOD K KOHLI |
| NPI Number: | 1770681470 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 4301-040989 |
| Business Practice Address: | 23700 Van Dyke Ave Warren, MI - 480891669 |
| Business Phone Number: | 5867596300 |
| Business Fax Number: | 5867591409 |
| Mailing Address: | 23700 Van Dyke Ave, WARREN |
| State: | MI |
| Postal Code: | 480891669 |
| Phone Number: | 5867596300 |
| Fax Number: | 5867591409 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 12/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301-040989 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |