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Individual

KENNETH CHARLES HANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
802 W KING ST, STE Q, OWOSSO, MI 48867
(989) 723-7619
(989) 723-0090
Mailing address
802 W KING ST, STE Q, OWOSSO, MI 48867
(989) 723-7619
(989) 723-0090

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301027519
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1007800511
BCBS OF MICHIGAN
MI
05
1097184
MI
Enumeration date
09/01/2006
Last updated
07/08/2007
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