Organization
DRS KETAI P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT STEVEN KETAI D.P.M. (PRESIDENT)
(248) 855-2220
Entity
Organization
Contact information
Practice address
31390 NORTHWESTERN HWY, SUITE E, FARMINGTON HILLS, MI 48334-2561
(248) 855-2220
(248) 855-1068
Mailing address
31390 NORTHWESTERN HWY, SUITE E, FARMINGTON HILLS, MI 48334-2561
(248) 855-2220
(248) 855-1068
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
RK000588
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F3632384812
MEDICARE PPI
MI
05
—
101877
—
MI
01
—
20721
OMNICARE HMO
MI
01
—
540F340180
BCBSM DME
MI
01
—
5635300
BLUE CROSSBLUE SHIELD
MI
01
—
80721
OMNICARE POS
MI
01
—
P76006
BCN
MI
Enumeration date
02/21/2007
Last updated
06/26/2009
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