Individual
DR. MARY ENA KUYVENHOVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
380 HOSPITAL DR STE 430, MACON, GA 31217-8017
(478) 751-0367
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01090044A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2020
Last updated
04/26/2024
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