MEDICARE: DR. CHARLES E KERR D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0007246	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z96017024	OTHER	MI	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568495406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES E KERR D.O.

Provider Business Mailing Address
First Line	:	801 JOE MANN BLVD STE P-6
Second Line	:
City	:	MIDLAND
State	:	MI
Zip	:	48642-8900
Country	:	US
Telephone Number	:	989-791-2455
Fax Number	:	989-791-1392

Provider Business Practice Location Address
First Line	:	1601 MARQUETTE ST
Second Line	:	STE 6
City	:	BAY CITY
State	:	MI
Zip	:	48706-4196
Country	:	US
Telephone Number	:	989-667-0561
Fax Number	:	989-667-0567

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	08/23/2022

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Directions to “ DR. CHARLES E KERR D.O.” Practice Location

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