Individual
KENNETH R. RETTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 CENTER STREET, STE 1S, MOBILE, AL 36604-3207
(251) 410-5437
(251) 434-3852
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 410-5437
(251) 434-3852
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
9210
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000015487
—
AL
05
—
00015345
—
MS
05
—
1722634
—
LA
05
—
255656100
—
FL
01
—
33-10016
UNITED HEALTH CARE
AL
01
—
51015487
BLUE CROSS
AL
Enumeration date
06/06/2006
Last updated
03/02/2017
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