Individual
KENNETH H FIFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
61 SANDY CREEK WAY, NOVATO, CA 94947-2071
(317) 457-2214
Mailing address
61 SANDY CREEK WAY, NOVATO, CA 94947-2071
(317) 457-2214
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
01030930
IN
207RI0200X
Infectious Disease Physician
G153225
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100071630
—
IN
Enumeration date
04/25/2006
Last updated
11/05/2018
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