Individual
DR. KEVIN GENE DREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3740 EDISON LAKES PKWY, MISHAWAKA, IN 46545-3448
(574) 252-4150
(574) 252-4159
Mailing address
3740 EDISON LAKES PKWY, MISHAWAKA, IN 46545-3448
(574) 252-4150
(574) 252-4159
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
01042863
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093083
ANTHEM BLUE CROSS BLUE SH
IN
05
—
103400810
—
MI
05
—
103506865
—
MI
05
—
104240346
—
MI
01
—
129646400
US DEPT OF LABOR
IN
05
—
200137230A
—
IN
01
—
250009418
RR MEDICARE
IN
01
—
250A110370
BLUE CROSS/SHIELD MICHIGA
MI
05
—
35205027103
—
MI
01
—
3520574
TRICARE HEALTHNET
IN
Enumeration date
06/15/2005
Last updated
11/03/2022
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