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Individual

MICHAEL WILLIAM KANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1004 W 1ST ST, BLOOMINGTON, IN 47403-2208
(812) 393-5534
(888) 532-2935
Mailing address
1004 W 1ST ST, BLOOMINGTON, IN 47403-2208
(812) 393-5534
(888) 532-2935

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01036858
IN
2084P0800X
Psychiatry Physician
Primary
01036858
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100185140
IN
Enumeration date
01/30/2007
Last updated
06/21/2024
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