KENNETH W DISTLER (NPI# 1598849903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598849903 |
| Entity Type | Individual |
| Full Name | KENNETH W DISTLER |
| Credential | MD |
| Practice Address |
2130 Marshall Ct Saginaw MI 48602-3351 |
| Practice Telephone | 9897990600 |
| Practice Fax Number | 9897996080 |
| Mailing Telephone | 9897990600 |
| Mailing Fax Number | 9897996080 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | KD046952 | MI | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1681561 | 05 | |
| MI | LICENSE | KD046952 | 01 |
| Street Address |
2130 MARSHALL CT |
| City | SAGINAW |
| State | MI |
| Zip Code | 48602-3351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770051575 | Nichole Marie Shuff | Physician Assistant | 2130 Marshall Ct, Saginaw, MI 48602-3351 | 2018-11-09 |
| 1184167595 | Joseph Yacisen, Do, PC | Specialist | 2130 Marshall Ct, Saginaw, MI 48602-3351 | 2016-12-02 |
| 1518125608 | Kenneth W Distler Md PC | Orthopaedic Surgery | 2130 Marshall Ct, Saginaw, MI 48602-3351 | 2008-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326665654 | Samuel R Olson | Student in an Organized Health Care Education/Training Program | Covenent Healthcare Cooper, 700 Cooper Avenue, Saginaw, MI 48602 | 2020-07-02 |
| 1871110726 | Quinn Murphy Ameel | Student in an Organized Health Care Education/Training Program | Cmed 1632 Stone St., Saginaw, MI 48602 | 2020-06-26 |
| 1730713322 | Abiola A Alaka | Student in an Organized Health Care Education/Training Program | 314 N Hamilton St, Saginaw, MI 48602 | 2020-02-24 |
| 1598235137 | Summer Dawn Broekhof | Speech-Language Pathologist | 515 N. Michigan, Saginaw, MI 48602 | 2018-11-27 |
| 1811486293 | Barbara Jean Hall | Physical Therapy Assistant | 500 S Hamilton, Saginaw, MI 48602 | 2018-05-01 |
| 1053808519 | Cst Counseling and Transitional Services Inc | Social Worker | 120 N Michigan Ave Ste 207, Saginaw, MI 48602 | 2018-04-19 |
| 1801325246 | Moregan Rose Lamarr | Social Worker | 304 South Niagara St, Saginaw, MI 48602 | 2017-06-08 |
| 1750818449 | Tamera Graham | Nurse Practitioner | 1447 N. Harrison St., Saginaw, MI 48602 | 2017-05-12 |
| 1831622109 | Brooke Vitale | Technician, Other | 1300 N. Michigan, Autism Plus, Saginaw, MI 48602 | 2017-04-04 |
| 1215387576 | Dorthia Eggleston | Specialist | 1203 Gratiot, Saginaw, MI 48602 | 2016-06-17 |
| Find all providers in zip 48602 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295078889 | Ashley Hendrick | Specialist | 3252 Kettering Rd, Saginaw, MI 48603-2316 | 2013-04-01 |
| 1275874877 | Kathy Anne Geiger | Specialist | 1609 Delaware St, Saginaw, MI 48602-4924 | 2013-03-06 |
| 1194961128 | Steven Richard Stidham Stone | Specialist | 1585 Amanda Dr, Saginaw, MI 48638-7392 | 2008-12-22 |
| 1013005578 | Mark Joseph Heinzelmann | Specialist | 4701 Towne Centre, Suite 104, Saginaw, MI 48604-8200 | 2006-10-10 |
| 1265527246 | Timberline Physicians, P.C. | Specialist | 800 S. Washington Ave., Saginaw, MI 48601 | 2006-10-04 |
| 1386735223 | Midwestern Surgical Associates PC | Specialist | 999 S Washington Avenue, Suite #2, Saginaw, MI 48601 | 2006-09-27 |
| 1659482347 | Albert Sm Manlapit M.d. Pllc | Specialist | 5453 Hampton Pl, Saginaw, MI 48604-9284 | 2006-08-31 |
| 1700997574 | Faith Abbott Do Plc | Specialist | 7326 Gratiot Rd, Saginaw, MI 48609-6909 | 2006-08-31 |
| 1821018706 | John Hugo Ansohn | Specialist | 204 Wj Boaz Rd Ste 200, Saginaw, TX 76179-4396 | 2006-07-20 |
| 1154365252 | Ernie Porteza Balcueva | Specialist | 4599 Towne Centre Rd Fl 2, Saginaw, MI 48604 | 2006-06-16 |
| Find all providers in SAGINAW | ||||
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| 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.