Provider Demographics
NPI:1215634944
Name:ABDUL BAKI, KINAN M (DC)
Entity type:Individual
Prefix:
First Name:KINAN
Middle Name:M
Last Name:ABDUL BAKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:KINAN
Other - Middle Name:M
Other - Last Name:ABDULBAKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:14618 LOVELAND ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3532
Mailing Address - Country:US
Mailing Address - Phone:248-982-1268
Mailing Address - Fax:
Practice Address - Street 1:6231 N CANTON CENTER RD STE 109
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2692
Practice Address - Country:US
Practice Address - Phone:734-455-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401394111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor