Kennedy, Michael T

Kennedy, Michael T is an individual health care provider with primary practice located at 148 Fairfield St , St Albans VT 05478-1729. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Kennedy, Michael T can be contacted via phone (802) 524-2168.

Contact Information

Primary practice address
148 Fairfield St St Albans VT 05478-1729
Phone: (802) 524-2168
Fax: (802) 524-0411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0420010044 Vermont

Profile Details

NPI number 1558351445
LBN Legal business name Kennedy, Michael T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Jul 8th, 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 1558351445 NPPES
Vermont Other 28637 BLUE CROSS BLUE SHIELD
Vermont Other 5269401 BLUE CROSS BLUE SHIELD
Vermont MEDICAID 0VN2288 BLUE CROSS BLUE SHIELD
Vermont Other 02V202 BLUE CROSS BLUE SHIELD

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