Individual
KENNETH J. KNOWLES II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF EMERGENCY MEDICINE, WORCESTER, MA 01655-0002
(508) 421-1400
(508) 421-1490
Mailing address
9 TINKHAM GLEN, WILBRAHAM, MA 01095
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
269932
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110111119A
—
MA
Enumeration date
03/24/2014
Last updated
02/06/2018
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