Individual
JERI W KESSENICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301048991
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3138473
—
MI
01
—
3504104761
BCBSM
MI
Enumeration date
01/20/2006
Last updated
10/01/2024
Update your record
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