Doctor Name: | MR. FREDERICK L. KYTE |
NPI Number: | 1205805660 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | 5601002179 |
Business Practice Address: | 2627 Ridgewood Trl Berrien Springs, MI - 491039777 |
Business Phone Number: | 2694732923 |
Business Fax Number: | |
Mailing Address: | 2627 Ridgewood Trl, BERRIEN SPRINGS |
State: | MI |
Postal Code: | 491039777 |
Phone Number: | 2694732923 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 5601002179 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |