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Individual

KELLY COLLEEN CUSHING-DAMM

Active
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Individual

KELLY COLLEEN CUSHING-DAMM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301114466
MI
207RG0100X
Gastroenterology Physician
Primary
4301114466
MI
208D00000X
General Practice Physician
2013017117
MO

Other

Enumeration date
06/19/2010
Last updated
11/16/2023
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