Kennedy, Marc V

Kennedy, Marc V is an individual health care provider with primary practice located at 10400 75Th St , Kenosha WI 53142-7884. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Kennedy, Marc V can be contacted via phone (262) 948-7000.

Contact Information

Primary practice address
10400 75Th St Kenosha WI 53142-7884
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 42142-020 Wisconsin

Profile Details

NPI number 1710900667
LBN Legal business name Kennedy, Marc V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Nov 3rd, 2023 - about last year

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 1710900667 NPPES
Wisconsin MEDICAID 33342300

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