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Individual

LARRY L KESTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
70 FULTON ST, PONTIAC, MI 48341-2755
(248) 338-0300
(248) 338-0663
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
4301065377
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1046262
HEALTH PLUS OF MICHIGAN THRU OAKLAND PHYSICIANS NETWORK SERVICES (OPNS)
MI
05
1073572434
MI
01
200812
UNITED HEALTHCARE COMMUNITY PLAN
MI
01
20974
HEALTH PLAN OF MICHIGAN
MI
01
320F362430
BCBSM
MI
01
7283213
AETNA THRU OAKLAND PHYSICIANS NETWORK SERVICES
MI
01
P01013933
RAILROAD MEDICARE
MI
Enumeration date
03/22/2006
Last updated
10/29/2012
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