Provider Demographics
NPI:1649355801
Name:CYNTHIA R AKS DO PC
Entity type:Organization
Organization Name:CYNTHIA R AKS DO PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:AKS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-285-8144
Mailing Address - Street 1:13383 REECK CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-3054
Mailing Address - Country:US
Mailing Address - Phone:734-285-8144
Mailing Address - Fax:734-285-8104
Practice Address - Street 1:13383 REECK RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-3054
Practice Address - Country:US
Practice Address - Phone:734-285-8144
Practice Address - Fax:734-285-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICA009351208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI134360OtherCARE CHOICES
MI0258213724OtherBCBS
MI14797OtherMCARE
MI020044482OtherRAILROAD MEDICARE
MI4124481Medicaid
MI020H232520OtherBCBSM
MIE83433OtherHAP
MI020044482OtherRAILROAD MEDICARE
MI020H232520OtherBCBSM