Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4301028695 | MI |
NPI | 1013016419 |
---|---|
Provider Name | Dr. Thomas M Keating |
First Address | Mount Pleasant, MI 48858-9752 |
Second Address | Mount Pleasant, MI 48858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 30/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2104990 | (05) | MI |
2373770 | BLUE CROSS BLUE SHIELD MI (01) | MI |
B43275 | (02) | MI |