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Norman Johnny Kakos

Internal Medicine

Allopathic & Osteopathic Physicians

32121 Woodward Ave, Suite 204, Royal Oak, MI 48073-6237

PECOS Enrollment

This provider is enrolled in PECOS as NORMAN KAKOS.

Based on the most recent information from CMS, provider Norman Johnny Kakos is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:21 AM.

Profile Details

Provider ID
1477621241
Provider Type
Individual
Full Name
Kakos, Norman Johnny
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
Yes
Enumeration Date
12/1/2006
Last Updated
5/17/2011

Contact Information

Practice Location

32121 Woodward Ave, Suite 204, Royal Oak, MI 48073-6237

(248) 399-5492

(248) 399-5792

Mailing Location

32121 Woodward Ave, Suite 204, Royal Oak, MI 48073-6237

(248) 399-5492

(248) 399-5792

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 4301068130 Michigan

Provider Identifiers

ID	Description	Issuer
ID 4422877	Description Medicaid	Issuer Unlisted Michigan
ID 1106334721	Description Other	Issuer BCBS BCN Michigan

Norman Johnny Kakos

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Berghea, Ramona

Abu Saleh, Nashat

Ammakola, Yagnapriya

Khanal, Pitambar

Bin Hameed, Usman

T N Kakish Md Pc

Alam, Anusha

Samala, Niharika R

Shelby-Lane, Cynthia A

Khanal, Dilip