| Colleen Kennedy Do Pc | |
|
75 Barclay Circle Suite 225 Rochester Hills MI 48307-4572 | |
| (248) 299-1892 | |
| (248) 299-1396 |
| Full Name | Colleen Kennedy Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 75 Barclay Circle, Rochester Hills, Michigan |
| Authorized Official Name and Position | Joanne S Goodrich (BILLING SUPERVISOR) |
| Authorized Official Contact | 2482991892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colleen Kennedy Do Pc 75 Barclay Circle Suite 225 Rochester Hills MI 48307-4572 Ph: (248) 299-1892 | Colleen Kennedy Do Pc 75 Barclay Circle Suite 225 Rochester Hills MI 48307-4572 Ph: (248) 299-1892 |
| NPI Number | 1295933000 |
|---|---|
| Provider Enumeration Date | 07/03/2007 |
| Last Update Date | 12/16/2010 |
| Medicare PECOS PAC ID | 0042263808 |
|---|---|
| Medicare Enrollment ID | O20050222000431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295933000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101012334 (Michigan) | Primary |
| Provider Name | Colleen M Kennedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538140744 PECOS PAC ID: 5395798151 Enrollment ID: I20050224000622 |
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