Individual
KENNETH GWINN
Active
Individual
KENNETH GWINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
KG050974
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000009639
CAPE HEALTH
MI
01
—
0405011981
BCBS
MI
01
—
131442
PREFERRED CHOICES
MI
01
—
258611
OMNICARE
MI
01
—
C7134
MCARE HMO
MI
Enumeration date
09/11/2006
Last updated
12/22/2011
Update your record
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