Individual
KENNETH WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 COLUMBUS AVE, BAY CITY, MI 48708-6831
(989) 894-3145
Mailing address
4100 EMBASSY DR SE, SUITE 200, GRAND RAPIDS, MI 49546-2416
(616) 975-1845
(616) 285-0846
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301046418
MI
207P00000X
Emergency Medicine Physician
Primary
4301046418
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301046418
MI
Other
Enumeration date
10/19/2006
Last updated
10/14/2014
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