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Individual

DR. COLLEEN M KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
75 BARCLAY CIR, SUITE 225, ROCHESTER HILLS, MI 48307-5820
(248) 299-1892
(248) 299-2396
Mailing address
75 BARCLAY CIRCLE, SUITE 225, ROCHESTER HILLS, MI 48307
(248) 299-1892
(248) 299-2396

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101012334
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0N22720
MEDICARE TYPE UNSPECIFIED
MI
Enumeration date
11/07/2005
Last updated
02/24/2011
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