Individual
MR. JOHN KETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
44199 DEQUINDRE RD STE 311, TROY, MI 48085
(248) 964-9490
(248) 964-9470
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3489
(947) 522-1867
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002242
MI
Other
Enumeration date
07/13/2006
Last updated
10/22/2020
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