Individual
KERRY L KOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684
(231) 935-7514
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-7514
(231) 392-0039
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101012055
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134176472
PRACTICE NPI
MI
05
—
4578920
—
MI
05
—
4604280
—
MI
01
—
5821108
BCBSM PIN NUMBER
MI
Enumeration date
10/20/2005
Last updated
10/22/2020
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