| Doctor Name: | KENNETH GWINN |
| NPI Number: | 1003910118 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | KG050974 |
| Business Practice Address: | 48681 Hayes Rd Shelby Township, MI - 483154403 |
| Business Phone Number: | 5867991212 |
| Business Fax Number: | 5867991210 |
| Mailing Address: | 48681 Hayes Rd, SHELBY TOWNSHIP |
| State: | MI |
| Postal Code: | 483154403 |
| Phone Number: | 5867991212 |
| Fax Number: | 5867991210 |
| NPI Enumeration Date: | 09/11/2006 |
| NPI Last Update Date: | 12/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207YX0905X |
| License Number: | KG050974 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Otolaryngology |
| Taxonomy Specialization: | Otolaryngology/Facial Plastic Surgery |
| Taxonomy Definition: | An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |