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Individual

DR. KEITH M TOBIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
28701 PLYMOUTH RD, LIVONIA, MI 48150-2335
(734) 427-9900
(734) 427-8963
Mailing address
28701 PLYMOUTH RD, LIVONIA, MI 48150-2335
(734) 427-9900
(734) 427-8963

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101010694
MI
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
5101010694
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4082200
MI
01
5101010694
STATE LICENSE NUMBER
MI
01
5820442
BCBS PROVIDER ID
MI
01
993699
AETNA PROVIDER ID
MI
01
C4002
MCARE PROVIDER ID
MI
01
F05096
HAP PROVIDER ID
MI
01
P86747
BCN PROVIDER ID
MI
Enumeration date
06/30/2005
Last updated
09/11/2025
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