Individual
DR. BRIAN JAMES KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
802 W KING ST STE M, OWOSSO, MI 48867-2100
(989) 729-4100
(989) 729-4066
Mailing address
802 W KING ST STE M, OWOSSO, MI 48867-2100
(989) 729-4100
(989) 729-4066
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301405919
MI
208M00000X
Hospitalist Physician
4301405919
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1944760
—
MI
01
—
700H161150
BLUE SHIELD
MI
Enumeration date
03/25/2006
Last updated
01/06/2025
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