Organization
KENNETH H MARKIEWICZ DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH H MARKIEWICZ D.O. (OWNER)
(616) 285-3733
Entity
Organization
Contact information
Practice address
2323 E PARIS AVE SE, GRAND RAPIDS, MI 49546-2414
(616) 285-3733
(616) 285-5960
Mailing address
2323 E PARIS AVE SE, GRAND RAPIDS, MI 49546-2414
(616) 285-3733
(616) 285-5960
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
5101007662
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0454111024
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
05
—
1642877
—
MI
Enumeration date
07/30/2008
Last updated
01/13/2009
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