Organization
KENNETH W DISTLER MD PC
Active
Organization
KENNETH W DISTLER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH W DISTLER MD (PRESIDENT)
(989) 799-0600
Entity
Organization
Contact information
Practice address
2130 MARSHALL CT, SAGINAW, MI 48602-3351
(989) 799-0600
(989) 799-6080
Mailing address
2130 MARSHALL CT, SAGINAW, MI 48602-3351
(989) 799-0600
(989) 799-6080
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1681561
—
MI
Enumeration date
05/27/2008
Last updated
05/27/2008
Update your record
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