Individual
KENNETH GRANT MASTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-3000
Mailing address
3990 JOHN R ST # 162, DETROIT, MI 48201-2018
(313) 745-7233
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
5101027678
MI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/22/2020
Last updated
08/05/2025
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