Provider Demographics
NPI:1255781746
Name:MOTYL, KENDRA HELENE (MD)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:HELENE
Last Name:MOTYL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:HELENE
Other - Last Name:MAURER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20225 E 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1700
Mailing Address - Country:US
Mailing Address - Phone:586-772-1090
Mailing Address - Fax:586-772-4366
Practice Address - Street 1:20225 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1700
Practice Address - Country:US
Practice Address - Phone:586-772-1090
Practice Address - Fax:586-772-4366
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301117043208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics