Individual
KEVIN ZETTEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(800) 968-6866
(616) 532-7230
Mailing address
DEPT CH 17767, PALATINE, IL 60055-7767
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101015741
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101015741
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5179420
—
MI
05
—
5179448
—
MI
05
—
5179466
—
MI
01
—
KZ015741
BLUE CROSS BLUE SHIELD
MI
01
—
P00432452
RAILROAD MEDICARE
—
Enumeration date
05/08/2007
Last updated
03/06/2008
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