Individual
KENNETH J BOTTESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
45634 SCHOENHERR RD, SHELBY TOWNSHIP, MI 48315-6024
(586) 566-3000
(586) 566-3070
Mailing address
45634 SCHOENHERR RD, SHELBY TOWNSHIP, MI 48315-6024
(586) 566-3000
(586) 566-3070
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301059564
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4592447
—
MI
05
—
4910630
—
MI
05
—
4910926
—
MI
Enumeration date
10/05/2005
Last updated
03/09/2009
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