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KENNETH E DUDLEY MD NPI 1891727244


NPI Information

NPI: 1891727244
Provider Name: KENNETH E DUDLEY, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
1787 GRAND RIDGE CT NE
SUITE 101
GRAND RAPIDS, MI
ZIP 49525
Phone: (616) 774-8131
Get Directions

Kenneth E Dudley, MD is a family medicine in Grand Rapids, MI. The provider is 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. Kenneth E Dudley, MD NPI is 1891727244. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1787 GRAND RIDGE CT NE
SUITE 101
GRAND RAPIDS, MI
ZIP 49525
Phone: (616) 774-8131
Fax: (616) 774-8204

The enumeration date for this NPI number is 7/7/2006 and was last updated on 12/3/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine4301043631MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10D1769004MEDICARE ID-TYPE UNSPECIFIED
20D17690OTHERMICHIGANBLUE CROSS BLUE SHIELD
3900000696OTHERMICHIGANPRIORITY HEALTH
42957039MEDICAIDMICHIGAN
50004553974OTHERMICHIGANAETNA
6B43215MEDICARE UPINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.