Individual
DR. KERRY MARK SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 MEMORIAL DR STE 1200, BERLIN, WI 54923-1243
(920) 361-5770
(920) 361-5779
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33205
WI
207Q00000X
Family Medicine Physician
4310075257
MI
Other
Enumeration date
09/30/2005
Last updated
12/31/2018
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