Individual
DR. KEVIN TISHKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
900 COOPER, SAGINAW, MI 48602
(989) 583-6122
(989) 583-2811
Mailing address
1447 N HARRISON ST, SAGINAW, MI 48602-4727
(989) 583-6122
(989) 583-2811
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101012277
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3486682
—
MI
Enumeration date
08/18/2006
Last updated
07/08/2007
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