# KMC INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407003965
- **Authorized official:** MRS. KIMBERLY KNAPP (MANAGER)
- **Authorized official phone:** (734) 946-8186

## Contact information

- **Practice address:** 24455 GODDARD RD, TAYLOR, MI 48180-3933
- **Practice address phone:** (734) 946-8186
- **Practice address fax:** (734) 946-4849
- **Mailing address:** 24455 GODDARD RD, TAYLOR, MI 48180-3933
- **Mailing address phone:** (734) 946-8186
- **Mailing address fax:** (734) 946-4849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/26/2008
- **Last updated:** 03/09/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 110H240910 | BCBSM PIN | MI |
| 01 | — | 1158218090 | BCBSM | MI |
| 01 | — | DK002533 | BCBSM LICENSE | MI |