Organization
NORTHERN MICHIGAN COSMETIC & RECONSTRUCTIVE SURGERY CENTER P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM J KANE MD (CEO)
(231) 487-6070
Entity
Organization
Contact information
Practice address
560 W MITCHELL ST, SUITE 360, PETOSKEY, MI 49770-2275
(231) 487-6070
(231) 487-6073
Mailing address
560 W MITCHELL ST, SUITE 360, PETOSKEY, MI 49770-2275
(231) 487-6070
(231) 487-6073
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
4301069905
MI
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
4301069604
MI
Other
Enumeration date
02/01/2008
Last updated
03/08/2011
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