Individual
KENNETH MARK WARDOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
16001 W 9 MILE RD, DEPT OF SURGERY, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Mailing address
16001 W 9 MILE RD, DEPT OF SURGERY, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002147
MI
363AS0400X
Surgical Physician Assistant
56010002147
MI
Other
Enumeration date
08/09/2005
Last updated
03/07/2023
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