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Organization
KMC INC
Active
Organization
KMC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY KNAPP (MANAGER)
(734) 946-8186
Entity
Organization
Contact information
Practice address
24455 GODDARD RD, TAYLOR, MI 48180-3933
(734) 946-8186
(734) 946-4849
Mailing address
24455 GODDARD RD, TAYLOR, MI 48180-3933
(734) 946-8186
(734) 946-4849
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H240910
BCBSM PIN
MI
01
—
1158218090
BCBSM
MI
01
—
DK002533
BCBSM LICENSE
MI
Enumeration date
08/26/2008
Last updated
03/09/2009
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