Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 4301068882 | MI |
NPI | 1477920510 |
---|---|
Provider Name | Dr. Yasmin Keshavjee |
First Address | Richmond, MI 48062-2505 |
Second Address | Warren, MI 48092-4272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2015 |
Last Update Date | 11/12/2018 |