Individual
DR. TIMOTHY MELVIN MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1675 WATERTOWER PLACE, SUITE 100, EAST LANSING, MI 48823
(517) 332-0200
(517) 332-0963
Mailing address
1675 WATERTOWER PLACE, SUITE 100, EAST LANSING, MI 48823
(517) 332-0200
(517) 332-0963
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101007174
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1544295
—
MI
Enumeration date
11/02/2005
Last updated
08/22/2011
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