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Individual

DR. NICOLE A KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6777 W MAPLE RD, DEPARTMENT OF VASCULAR SURGERY, WEST BLOOMFIELD, MI 48322-3013
(248) 325-3087
(248) 325-0071
Mailing address
6777 W MAPLE RD, DEPARTMENT OF VASCULAR SURGERY, WEST BLOOMFIELD, MI 48322-3013
(248) 325-3087
(248) 325-0071

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301081948
MI
2086S0129X
Vascular Surgery Physician
Primary
4301081948
MI

Other

Enumeration date
05/21/2007
Last updated
04/26/2013
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