Individual
DR. KENNETH HIROSHI KANESHIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
230 TEMPLE ST, MASON, MI 48854-1837
(517) 676-9066
(517) 676-3505
Mailing address
230 TEMPLE ST, PO BOX 39, MASON, MI 48854-1837
(517) 676-9066
(517) 676-3505
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
4301050328
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-00217
PHPMM
MI
01
—
0170217
PHPFC
MI
01
—
KK050328
BCBS
MI
01
—
P94722
BCN
MI
Enumeration date
05/05/2006
Last updated
12/05/2007
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