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Kenneth Tarter
Military Health Care Provider in Detroit, Michigan
NPI 1255039210

Kenneth Tarter is a Military Health Care Provider based in Detroit, MI. Kenneth Tarter practices in Detroit, MI. The NPI Number for Kenneth Tarter is 1255039210 and holds a License No. (Michigan).

The current practice location address for Kenneth Tarter is 2004 E Lafayette St, Detroit, MI and can be reached out via phone at 248-508-6039.

Location: 2004 E Lafayette St, Detroit, MI, 48207-3949
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255039210
Provider Name
Kenneth Tarter
Credential
Provider Entity Type
Individual
Gender
Male
Address
2004 E Lafayette St, Detroit, MI, 48207-3949
Phone Number
248-508-6039
Fax Number
Provider Enumeration Date
02/20/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2004 E Lafayette St
City
Detroit
State
Michigan
Zip
48207-3949
Phone Number
248-508-6039
Fax Number
person
Provider Business Mailing Address Details
Address
2004 E Lafayette St
City
Detroit
State
Michigan
Zip
48207-3949
Phone Number
248-508-6039
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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