Provider Demographics
NPI:1902132731
Name:AWOON PLLC
Entity type:Organization
Organization Name:AWOON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:FOLEY
Authorized Official - Last Name:KABISCH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-971-5483
Mailing Address - Street 1:2330 E STADIUM BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4820
Mailing Address - Country:US
Mailing Address - Phone:734-971-5483
Mailing Address - Fax:734-971-7585
Practice Address - Street 1:2330 E STADIUM BLVD STE 2
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4820
Practice Address - Country:US
Practice Address - Phone:734-971-5483
Practice Address - Fax:734-971-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL998169261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1295800498OtherDR THOMAS KABISCH NPI #