Individual
DR. MARCUS KYLE FREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2143 DERFLA DR, SAINT JOSEPH, MI 49085-9661
(888) 550-5154
(888) 414-4545
Mailing address
2143 DERFLA DR, SAINT JOSEPH, MI 49085-9661
(810) 404-2521
(888) 414-4545
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301093347
MI
208600000X
Surgery Physician
L0799
TX
208D00000X
General Practice Physician
4301093347
MI
208D00000X
General Practice Physician
Primary
LO799
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105431333
—
MI
Enumeration date
07/16/2008
Last updated
10/27/2019
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