Provider Demographics
NPI:1134124209
Name:KERWIN, HOWARD B (DO)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:B
Last Name:KERWIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:15520 19 MILE RD
Mailing Address - Street 2:STE 480
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6332
Mailing Address - Country:US
Mailing Address - Phone:586-228-1010
Mailing Address - Fax:586-228-8570
Practice Address - Street 1:15520 19 MILE RD
Practice Address - Street 2:STE 480
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-6332
Practice Address - Country:US
Practice Address - Phone:586-228-1010
Practice Address - Fax:586-228-8570
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101008611207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1155000615OtherBLUE CROSS/SHIELD MICHIGA
MI1999965Medicaid
MI1155000615OtherBLUE CROSS/SHIELD MICHIGA
MIE25974Medicare UPIN