MEDICARE: DREW KERSJES

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	104100000X	Social Worker	6801103988	MI
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1023624343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DREW KERSJES

Provider Business Mailing Address
First Line	:	4428 MARGARET DR
Second Line	:
City	:	CHARLOTTE
State	:	MI
Zip	:	48813-7646
Country	:	US
Telephone Number	:	517-652-5325
Fax Number	:	517-323-9531

Provider Business Practice Location Address
First Line	:	5123 W ST JOE HWY STE 103
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-4028
Country	:	US
Telephone Number	:	517-323-4099
Fax Number	:

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

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	09/22/2020

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Directions to “ DREW KERSJES ” Practice Location

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