DR. MICHAEL J KENNESON (NPI# 1154391969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154391969 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J KENNESON |
| Credential | D.O. |
| Practice Address |
42645 Garfield Rd Suite 103 Clinton Twp MI 48038-5022 |
| Mailing Address |
43900 Garfield Rd Ste 222 Clinton Township MI 48038-1137 |
| Practice Telephone | 5862860050 |
| Practice Fax Number | 5862860880 |
| Mailing Telephone | 5862860050 |
| Mailing Fax Number | 5862860880 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2018-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101010986 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4381308 | 05 | |
| MI | 4991989 | 05 |
| Street Address |
42645 GARFIELD RD SUITE 103 |
| City | CLINTON TWP |
| State | MI |
| Zip Code | 48038-5022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407836653 | Russell C Chavey | Family Medicine | 42645 Garfield Rd, Suite 103, Clinton Twp, MI 48038-5022 | 2006-01-21 |
| 1689654832 | James Cho | Family Medicine | 42645 Garfield Rd, Suite 103, Clinton Twp, MI 48038-5022 | 2006-01-21 |
| 1679553838 | Wasim A Rathur | Family Medicine | 42645 Garfield Rd, Suite 103, Clinton Twp, MI 48038-5022 | 2006-01-21 |
| 1952381113 | Christina Louise Winder | Family Medicine | 42645 Garfield Rd, Suite 103, Clinton Twp, MI 48038-5022 | 2006-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864129 | Raphael Antonio Tramble | Counselor | River Oaks Suites Plaza 42815 Garfield Road, Suite 201, Clinton Township, MI 48038 | 2020-09-01 |
| 1275160384 | Varun C Sankuratri | Obstetrics & Gynecology | 16515 Nineteen Mile Rd, Gme Office: Attention Obgyn PC Kelly Bennet, Clinton Township, MI 48038 | 2020-03-26 |
| 1114563178 | Hopeful Reflections Counseling Center, Pllc | Counselor | 44444 Hayes, Clinton Township, MI 48038 | 2019-11-25 |
| 1588224570 | Karrie Marie Armstrong | Social Worker | 42815 Garfield Rd Macomb Therapy Group, Suite 201, Clinton Twp, MI 48038 | 2019-06-20 |
| 1386201424 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr Ste #2, Clinton Twp, MI 48038 | 2019-05-23 |
| 1306314489 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr., Suite 2, Clinton Twp, MI 48038 | 2018-11-07 |
| 1730677592 | Najoi Sleiman | Physical Medicine & Rehabilitation | 15855 19-mile Road, Rehab Services, 4th Floor, South Tower, Clinton Twp., MI 48038 | 2018-04-27 |
| 1295230365 | David Michael Ragbeer | Emergency Medicine | Henry Ford Macomb Hospitals, 15855 Nineteen Mile Road, Clinton Township, MI 48038 | 2018-03-29 |
| 1932601317 | Synergy Pharmacy LLC | Pharmacy | 42621 Garfield Rd Ste 101a, Clinton Township, MI 48038 | 2018-03-01 |
| 1689175002 | Melissa Velez Miracle | Speech-Language Pathologist | 38809 Windmill Pointe W, Clinton Twp, MI 48038 | 2018-02-21 |
| Find all providers in zip 48038 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073776456 | Reynold M John, Md, PC | Family Medicine | 43171 Dalcoma Dr Ste 6, Clinton Twp, MI 48038-6307 | 2008-07-07 |
| 1205840691 | Iris Bourbon Daniel | Family Medicine | 42490 Garfield, Suite 207, Clinton Twp, MI 48038 | 2006-07-28 |
| 1093767683 | Thao Phuong Pham | Family Medicine | 15717 15 Mile Rd, Clinton Twp, MI 48035-2101 | 2006-05-16 |
| 1265482095 | Mark Robert Kurzawa | Family Medicine | 36367 Harper Ave, Clinton Twp, MI 48035-2958 | 2006-05-11 |
| 1013988773 | Albert Anthony Przybylski | Family Medicine | 36549 Harper Ave, Suite B, Clinton Twp, MI 48035-2012 | 2006-01-31 |
| 1619956497 | John R Pradko | Family Medicine | 33720 Harper Ave, Suite A, Clinton Twp, MI 48035 | 2006-01-11 |
| 1336130632 | Charles E Heth | Family Medicine | 42855 Garfield Rd, Ste 105, Clinton Twp, MI 48038-5027 | 2005-11-04 |
| 1417946815 | Paul Richard Gradolph | Family Medicine | 43421 Garfield Rd, Ste 1, Clinton Twp, MI 48038-1133 | 2005-10-18 |
| 1346240124 | Cynthia Marie Trosin | Family Medicine | 35103 Silvano St, Clinton Twp, MI 48035-2685 | 2005-07-22 |
| 1174521207 | Pamela Rae Valka | Family Medicine | 37399 Garfield, Suite 203, Clinton Twp, MI 48036-3659 | 2005-07-12 |
| Find all providers in CLINTON TWP | ||||
| City | CLINTON TWP |
| Zip Code | 48038 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.