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Individual
GLENN EVAN KERSHEN
Active
Individual
GLENN EVAN KERSHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
GK075761
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0987964
HEALTHPLUS
MI
01
—
340020605
RAILROAD MEDICARE
MI
01
—
340G310500
BLUE CROSS
MI
05
—
4433790
—
MI
01
—
7792123
AETNA
MI
01
—
H11966
TRI CARE
MI
Enumeration date
08/24/2005
Last updated
03/30/2021
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