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Individual

DR. KENNETH JEFFREY WOODSIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3637 BRIARLEE WAY, ANN ARBOR, MI 48103-9461
(734) 369-2161
Mailing address
3637 BRIARLEE WAY, ANN ARBOR, MI 48103-9461
(734) 369-2161

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35-093946
OH
208600000X
Surgery Physician
Primary
4301088944
MI
208600000X
Surgery Physician
M2206
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01940834
TX. DRIVER'S LICENSE
TX
05
2962398
OH
Enumeration date
06/05/2006
Last updated
07/30/2026
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