Kennedy, Stephen D

Kennedy, Stephen D is an sole proprietor health care provider with primary practice located at 5838 W Brick Rd Ste 106 , South Bend IN 46628. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kennedy, Stephen D can be contacted via phone (574) 247-1911.

Contact Information

Primary practice address
5838 W Brick Rd Ste 106 South Bend IN 46628
Phone: (574) 247-1911
Fax: (574) 247-1912
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101013733 Michigan
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02001650A Indiana

Profile Details

NPI number 1700885498
LBN Legal business name Kennedy, Stephen D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 15th, 2005
Last updated Feb 22nd, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1700885498 NPPES
Indiana MEDICAID 200081840A

Popular Providers