Individual
MICHAEL PATRICK KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1650 S 41ST ST, MANITOWOC, WI 54220-7316
(920) 320-5251
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2591
(920) 320-5106
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD24078
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181882
—
OR
Enumeration date
08/03/2006
Last updated
01/10/2013
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