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Contact Information

MARC V KENNEDY, MD
10400 75TH ST
KENOSHA, WI53142-7884
 Phone: 262-948-7000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for MARC V KENNEDY · (Male)

NPI # 1710900667
Status Active
Credentials MD
Entity Individual
Enumeration date 07/25/2006
Last updated 11/03/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 42142-020
  • WI Medicaid 33342300
Hospital affiliation(s)
  • AURORA MED CTR KENOSHA - (Acute Care)
    10400 75TH ST
    KENOSHA, WI 53142
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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