| Kenneth MD PLC | |
|
4100 River Rd East China MI 48054-2909 | |
| (810) 329-7111 | |
| Not Available |
| Full Name | Kenneth MD PLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 4100 River Rd, East China, Michigan |
| Authorized Official Name and Position | Lynn Justusson (VP) |
| Authorized Official Contact | 2487430396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth MD PLC 6383 Glyndebourne Dr Troy MI 48098-2214 Ph: (586) 960-5358 | Kenneth MD PLC 4100 River Rd East China MI 48054-2909 Ph: (810) 329-7111 |
| NPI Number | 1831603596 |
|---|---|
| Provider Enumeration Date | 11/16/2017 |
| Last Update Date | 12/27/2019 |
| Certification Date | 12/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831603596 | NPI | - | NPPES |
| 4301100071 | Other | MI | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301100071 (Michigan) | Primary |
Henry Ford River District Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4100 S River Rd, East China, MI 48054 Phone: 800-848-0202 Fax: 586-226-6949 |
St. Clair Infectious Diseases PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4050 River Rd, Ste 2, East China, MI 48054 Phone: 810-329-2268 Fax: 810-329-0966 |
Mark T. O'brien, D.O., P.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4150 River Rd, Suite F2, East China, MI 48054 Phone: 810-329-4660 Fax: 810-329-4699 |
Medflex P.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4220 Hospital Dr, East China, MI 48054 Phone: 810-329-4736 |
Thomas G. Wayne M.D., P.L.L.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4150 S River Rd, Suite1, East China, MI 48054 Phone: 810-326-0858 Fax: 810-326-0933 |
Laura Lucio-reincke, PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3436 S River Rd, Ste B, East China, MI 48054 Phone: 810-326-3540 Fax: 810-326-3541 |