Individual
KATHERINE ANN KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9045 US HIGHWAY 31, BERRIEN SPRINGS, MI 49103-1804
(269) 473-2222
(269) 473-6880
Mailing address
9045 US HIGHWAY 31, BERRIEN SPRINGS, MI 49103-1804
(269) 473-2222
(269) 473-6880
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301081055
MI
208000000X
Pediatrics Physician
4301081055
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104694670
—
MI
01
—
1902086689
GROUP NPI
MI
01
—
700A146860
BCBSM GROUP PIN
MI
01
—
P17270001
MEDICARE INDIVIDUAL PTAN
MI
Enumeration date
01/18/2006
Last updated
11/26/2019
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