# DR. MARSHALL KEVIN MEDLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1225138340
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 5101013769 | MI | Yes |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 11/17/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000012192 | CAPE HEALTH PLAN | MI |
| 01 | — | 0007367710 | AETNA | MI |
| 01 | — | 141412 | CARE CHOICES | MI |
| 01 | — | 17178 | MCARE | MI |
| 05 | — | 4774341 | — | MI |
| 01 | — | 5821256 | BLUE CROSS BLUE SHIELD | MI |
| 01 | — | P36227-F | BLUE CARE NETWORK | MI |
| 01 | — | U92085 | PRIVATE HEALTH CARE SYSTE | MI |