Kissel, Charles Gregory

Kissel, Charles Gregory is an individual health care provider with primary practice located at 29433 Ryan Rd , Warren MI 48092-2203. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Kissel, Charles Gregory can be contacted via phone (586) 574-0500.

Contact Information

Primary practice address
29433 Ryan Rd Warren MI 48092-2203
Phone: (586) 574-0500
Fax: (586) 574-2694
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 5901000960 Michigan

Profile Details

NPI number 1982606414
LBN Legal business name Kissel, Charles Gregory
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2005
Last updated Oct 24th, 2014 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982606414 NPPES
Michigan MEDICAID 4949617
Michigan Other 480F330020
Michigan MEDICAID 1715614
Michigan Other 480E011810
Michigan MEDICAID 2932693
Michigan MEDICAID 4585272
Michigan Other T34053
Michigan Other 480F335300
Michigan Other 480Q24567

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