Individual
KERMITH SCARLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1808 S PENNSYLVANIA AVE, STE A, LANSING, MI 48910-1897
(517) 268-6608
(517) 268-6609
Mailing address
PO BOX 23068, LANSING, MI 48909-3068
(517) 267-1270
(517) 267-1272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
KS009329
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153303015
BCBS
MI
05
—
3105211
—
MI
01
—
KS009329
LIC #
MI
Enumeration date
10/26/2007
Last updated
01/10/2017
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