Provider Demographics
NPI:1225029564
Name:KERCHIEF, KARL ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:ROBERT
Last Name:KERCHIEF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13320 N BOULEVARD ST
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49097-1514
Mailing Address - Country:US
Mailing Address - Phone:269-649-2012
Mailing Address - Fax:269-649-3752
Practice Address - Street 1:13320 N BOULEVARD ST
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MI
Practice Address - Zip Code:49097-1514
Practice Address - Country:US
Practice Address - Phone:269-649-2012
Practice Address - Fax:269-649-3752
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2017-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301091766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M04700Medicare PIN