DR. MARK DAVID KIDWELL (NPI# 1366892150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366892150 |
| Entity Type | Individual |
| Full Name | DR. MARK DAVID KIDWELL |
| Credential | D.O. |
| Practice Address |
3955 Patient Care Dr Ste A Lansing MI 48911 |
| Mailing Address |
3955 Patient Care Dr Ste A Lansing MI 48911-4271 |
| Practice Telephone | 5173747600 |
| Practice Fax Number | 8554955457 |
| Mailing Telephone | 5173747600 |
| Mailing Fax Number | 5173747600 |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2019-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101022590 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 E Michigan Ave, Suite 245, Lansing, MI 489121800 | 5173645252 |
| Street Address |
3955 PATIENT CARE DR STE A |
| City | LANSING |
| State | MI |
| Zip Code | 48911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932180148 | Mark W. Schaar | Family Medicine | 3955 Patient Care Dr Ste A, Lansing, MI 48911-4271 | 2005-11-07 |
| 1912529751 | Erika Isela Hurt | Registered Nurse | 3955 Patient Care Dr Ste A, Lansing, MI 48911-4271 | 2020-05-14 |
| 1053941674 | Nicole Vanderstelt | Physician Assistant | 3955 Patient Care Dr Ste A, Lansing, MI 48911-4271 | 2020-01-23 |
| 1760012348 | Richard Daniel Szczesny | Physician Assistant | 3955 Patient Care Dr Ste A, Lansing, MI 48911-4271 | 2020-01-22 |
| 1255973236 | Kaitlyn Rose Kowalczyk | Nurse Practitioner | 3955 Patient Care Dr Ste A, Lansing, MI 48911-4271 | 2019-10-11 |
| 1811462450 | Katarina Leclair | Nurse Practitioner | 3955 Patient Care Dr Ste A, Lansing, MI 48911-4271 | 2018-10-10 |
| 1922539717 | Garrett Descoteaux-friday | Internal Medicine | 3955 Patient Care Dr Ste A, Lansing, MI 48911-4271 | 2017-03-23 |
| 1508301383 | Amanda Rose Koester | Nurse Practitioner | 3955 Patient Care Dr Ste A, Lansing, MI 48911-4271 | 2017-01-03 |
| 1174068050 | Erin Warriner | Nurse Practitioner | 3955 Patient Care Dr Ste A, Lansing, MI 48911-4271 | 2016-12-30 |
| 1114470036 | Kristal Richardson-aubrey | Nurse Practitioner | 3955 Patient Care Dr Ste A, Lansing, MI 48911-4271 | 2016-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943603 | Promissa Personalized Care Services LLC | Assisted Living Facility | 200 E Edgewood Blvd, Lansing, MI 48911 | 2020-05-07 |
| 1457911877 | Zachary Todd Goldstein | Pediatrics | Cedar Pediatrics 5303 S. Cedar St, Suite 205, Lansing, MI 48911 | 2019-06-18 |
| 1447713946 | Fadi Nuseibeh | Pharmacist | 3955 Patient Care Drive, Pharmacy, Lansing, MI 48911 | 2019-04-11 |
| 1740704543 | Kyle Lardie | Dental Hygienist | Care Free Medical and Dental 5135 S Pennsylvania Ave, Lansing, MI 48911 | 2017-08-02 |
| 1124549845 | Joash Michael Charles | Behavior Technician | 3720 Richmond Street, Lansing, MI 48911 | 2017-07-03 |
| 1205212164 | Benjamin Curtis Neal | Dentist | 5601 S Cedar St., Lansing, MI 48911 | 2015-08-03 |
| 1376927608 | Heather Lamb | Home Health | 2919 Risdale St, Lansing, MI 48911 | 2015-07-16 |
| 1669861712 | Lucas James Evan Joseph Bila | Licensed Practical Nurse | 2204 S. Wadsworth Dr, Lansing, MI 48911 | 2015-01-13 |
| 1649695271 | Aaron James Hart | Occupational Therapist | 3960 Patient Care Dr Ste 117, Lansing, MI 48911 | 2014-02-18 |
| 1831465871 | Los Equipment Corporation | Dentist | 6810 S. Cedar St, Suite 5, Lansing, MI 48911 | 2012-03-23 |
| Find all providers in zip 48911 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074773 | Craig Hargurkirat Malli | Family Medicine | 1215 E Michigan Avenue Suite 245, Lansing, MI 48912 | 2020-05-08 |
| 1215558945 | Temmy J. Brotherson | Family Medicine | Sparrow Health Systems, 1200 E Michigan Avenues, Suite 245, Lansing, MI 48912 | 2020-05-05 |
| 1083104673 | Andersen Medical Group, LLC | Family Medicine | 712 1st Ter # 205, Lansing, KS 66043 | 2018-05-18 |
| 1952783847 | Ravinder Singh Dhillon | Family Medicine | 3001 Trappers Cove Trl, Apt 3035 1a, Lansing, MI 48910-5770 | 2015-06-26 |
| 1407272206 | Suma Thomas | Family Medicine | 1540 Lake Lansing Rd Ste 202, Lansing, MI 48912-3757 | 2014-03-17 |
| 1881955920 | Abigail Urish | Family Medicine | 1200 E Michigan Ave Ste 245-c, Lansing, MI 48912-1800 | 2012-06-05 |
| 1598077216 | Gregory A Lawson | Family Medicine | 1200 E Michigan Ave, Ste 245, Lansing, MI 48912-1897 | 2010-07-10 |
| 1235441528 | Kristy Anne Beckholt | Family Medicine | 1215 E Michigan Ave 7th Fl Tower West, Lansing, MI 48912 | 2010-07-02 |
| 1790949667 | Luis G Valle | Family Medicine | 500 E Thomas St, Lansing, MI 48906-6118 | 2008-07-10 |
| 1174708622 | Peter D Cotey | Family Medicine | Lansing Va Cboc, 2025 S Washington Ave, Lansing, MI 48910 | 2008-01-03 |
| Find all providers in LANSING | ||||
Please comment or provide details below to improve the information on DR. MARK DAVID KIDWELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.