OrganizationT N Kakish Md PcInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address32121 Woodward Ave, Suite 204, Royal Oak, MI 48073-6237(248) 399-5492PECOS EnrollmentBased on the most recent information from CMS, provider T N Kakish Md Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:21 AM.Profile DetailsProvider ID1629146493Provider TypeOrganizationFull NameT N Kakish Md PcSubpartNoEnumeration Date12/1/2006Last Updated8/14/2015Contact InformationPractice LocationPractice Address32121 Woodward Ave, Suite 204, Royal Oak, MI 48073-6237Phone(248) 399-5492Fax(248) 399-5792Mailing LocationMailing Address32121 Woodward Ave, Suite 204, Royal Oak, MI 48073-6237Phone(248) 399-5492Fax(248) 399-5792Authorized OfficialNameKakish, Tariq (Owner Physician)Phone(248) 399-5492Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense4301067872MichiganProvider IdentifiersIDDescriptionIssuerID110F338390DescriptionOtherIssuerBCN GROUPMichiganID1629146493DescriptionMedicaidIssuerUnlistedMichiganIDDG3482DescriptionOtherIssuerMEDICARE RAILROADMichiganID110F338390DescriptionOtherIssuerBC GROUPMichigan