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General NPI Number Information
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NPI Number | 1376709337
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Entity Type | Organization
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Legal Business Name | KENNETH H MARKIEWICZ DO PC
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 2323 E PARIS AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2414
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Country | US
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Telephone | 616-285-3733
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Fax | 616-285-5960
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Provider Business Mailing Address
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Address Line | 2323 E PARIS AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2414
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Country | US
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Telephone | 616-285-3733
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Fax | 616-285-5960
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH H MARKIEWICZ
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Credential | D.O.
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Telephone | 616-285-3733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 5101007662
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License Number State | MI
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