Healthcare Provider Details

I. General information

NPI: 1619557956
Provider Name (Legal Business Name): JULIA KERWIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5694 MIDLAND RD
FREELAND MI
48623-8845
US

IV. Provider business mailing address

5694 MIDLAND RD
FREELAND MI
48623-8845
US

V. Phone/Fax

Practice location:
  • Phone: 989-695-2123
  • Fax: 989-695-2316
Mailing address:
  • Phone: 989-695-2123
  • Fax: 989-695-2316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301511146
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: