Provider Demographics
NPI:1144539081
Name:KIEHL, MICHAEL R (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:KIEHL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:32743 23 MILE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2176
Mailing Address - Country:US
Mailing Address - Phone:708-424-3201
Mailing Address - Fax:708-424-5001
Practice Address - Street 1:5300 SOCIALVILLE FOSTER RD STE 160
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9429
Practice Address - Country:US
Practice Address - Phone:513-844-8585
Practice Address - Fax:513-844-8769
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003591213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0051180Medicaid
OHH021900Medicare PIN
OHP00976419Medicare PIN
OH0051180Medicaid
OHH021901Medicare PIN