Healthcare Provider Details

I. General information

NPI: 1053250514
Provider Name (Legal Business Name): ANTHONY KUHBANDER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 E CHICAGO RD
STURGIS MI
49091-1993
US

IV. Provider business mailing address

701 FRIAR TUCK ST
STURGIS MI
49091-9158
US

V. Phone/Fax

Practice location:
  • Phone: 269-633-4108
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704353866
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: