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Individual

DR. KENNETH W FRIAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1105 6TH ST, TRAVERSE CITY, MI 49684-2349
(231) 947-0673
(801) 740-2847
Mailing address
PO BOX 107, TRAVERSE CITY, MI 49685-0107
(231) 947-0673
(801) 740-2847

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301056539
MI
207R00000X
Internal Medicine Physician
Primary
4301056539
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4326594
MI
01
KF056539
BLUE CROSS BLUE SHIELD
Enumeration date
06/15/2005
Last updated
09/14/2007
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