Individual
DWIGHT R. MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 NOTT ST, @ ELLIS HOSPITAL ER DEPT., SCHENECTADY, NY 12308-2425
(518) 243-4121
Mailing address
200 W NORTHFIELD CHURCH RD, ANN ARBOR, MI 48105-9645
(734) 214-0939
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
162886-1
NY
207R00000X
Internal Medicine Physician
162886-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01732301
—
NY
Enumeration date
07/28/2006
Last updated
12/14/2007
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