Provider Demographics
NPI:1639330624
Name:KUNZER, KEVIN ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ANTHONY
Last Name:KUNZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:ANTHONY
Other - Last Name:KUNZER, MD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4328 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-5823
Mailing Address - Country:US
Mailing Address - Phone:269-375-2222
Mailing Address - Fax:269-375-8292
Practice Address - Street 1:4328 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-5823
Practice Address - Country:US
Practice Address - Phone:269-375-2222
Practice Address - Fax:269-375-8292
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010927782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0390750OtherBCBS