Individual
KEVIN BRADLEY LODEWYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 W NORTH ST, GAYLORD, MI 49735-1525
(989) 732-6455
Mailing address
PO BOX 1665, GAYLORD, MI 49734-5665
(989) 732-6455
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301112664
MI
207W00000X
Ophthalmology Physician
Primary
4301506618
MI
Other
Enumeration date
06/23/2017
Last updated
12/15/2022
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