Individual
R KEVIN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 1ST FLOOR CANCER & GERIATRICS CTR RECP C, ANN ARBOR, MI 48109-5902
(734) 647-8906
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301053833
MI
207VX0201X
Gynecologic Oncology Physician
4301053833
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1988863
—
MI
Enumeration date
10/05/2006
Last updated
03/29/2012
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