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Individual

DR. KENNETH R CERVONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
24715 LITTLE MACK, STE 100, ST CLAIR SHORE, MI 48080
(586) 779-7970
(586) 779-7748
Mailing address
24715 LITTLE MACK AVE, SUITE 100, SAINT CLAIR SHORES, MI 48080-3207
(586) 779-7970
(586) 779-7748

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301058405
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3250375
MI
Enumeration date
10/26/2005
Last updated
02/19/2014
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