Individual
KENNETH WALTER BEROZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1021 S KINNEY STREET, MT PLEASANT, MI 48858
(989) 773-5095
(989) 772-2827
Mailing address
PO BOX 336, MT PLEASANT, MI 48804
(989) 773-5095
(989) 772-2827
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301054743
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301054743
MEDICINE PERMANENT ID
MI
Enumeration date
01/04/2007
Last updated
05/07/2008
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