Provider Demographics
NPI:1902023963
Name:WERBACK, KELLY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ANN
Last Name:WERBACK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1100 S VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413-9615
Mailing Address - Country:US
Mailing Address - Phone:989-269-2881
Mailing Address - Fax:989-269-1562
Practice Address - Street 1:1011 S VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413-9630
Practice Address - Country:US
Practice Address - Phone:989-269-6990
Practice Address - Fax:989-269-8054
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2020-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301085457207VX0000X, 207VH0002X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative Medicine