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Individual

DR. KIMBERLY A PUMMILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8384 HOLLY RD, SUITE 1, GRAND BLANC, MI 48439-7335
(810) 606-7888
(810) 606-6864
Mailing address
8384 HOLLY RD, SUITE 1, GRAND BLANC, MI 48439-1976
(810) 606-7888
(810) 606-6864

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
4301070280
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0251130
BLUE CROSS/BLUE SHIELD
MI
01
0993473
HEALTHPLUS
MI
01
0P13640
MEDICARE GROUP PTAN
MI
01
14465
MCARE
MI
01
300073509
COMMERCIAL INSURANCE
MI
05
4469908
MI
01
6U4349
HAP
MI
Enumeration date
06/10/2006
Last updated
01/22/2014
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