NPI 1023235520

Kelly McIntosh, PAC

Practitioner Physician Assistant West Bloomfield, MI

Practice location

Address: 6777 W Maple Rd, West Bloomfield, MI 48322-3013
Phone: (248) 325-1000
Mailing address: 324 N Harvey St, Plymouth, MI 48170-1223

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 5601004080 (MI)

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Registry record

NPI: 1023235520
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Apr 2007
Record last updated: 15 Feb 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.