Individual
KEVIN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
827 E DIVISION ST, CADILLAC, MI 49601-2015
(231) 775-9741
(231) 775-9333
Mailing address
827 E DIVISION ST, CADILLAC, MI 49601-2015
(231) 775-9741
(231) 775-9333
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
KA075594
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0808300492
BLUE CROSS/SHIELD INDIVIU
MI
01
—
0H36303
BLUE CROSS/SHIELD GROUP
MI
01
—
127350
PREFERRED CHOICE
MI
01
—
1942202916
RAILROAD MEDICARE
MI
05
—
4217007
—
MI
05
—
4501451
—
MI
05
—
4501451-10
—
MI
Enumeration date
08/10/2005
Last updated
12/01/2016
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