Distler, Kenneth W

Distler, Kenneth W is an sole proprietor health care provider with primary practice located at 2130 Marshall Ct , Saginaw MI 48602-3351. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Distler, Kenneth W can be contacted via phone (989) 799-0600.

Contact Information

Primary practice address
2130 Marshall Ct Saginaw MI 48602-3351
Fax: (989) 799-6080
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X KD046952 Michigan

Profile Details

NPI number 1598849903
LBN Legal business name Distler, Kenneth W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598849903 NPPES
Michigan MEDICAID 1681561
Michigan Other KD046952

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