Individual
DR. KEITH J. MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1501 W CHISHOLM ST, ALPENA, MI 49707-1401
(989) 340-1211
(989) 340-1214
Mailing address
10850 E TRAVERSE HWY, STE 4400, TRAVERSE CITY, MI 49684-1364
(231) 346-6800
(989) 340-1214
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101008328
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1006214
MCLAREN HEALTH PLAN
MI
01
—
110197522
UNITED HEALTHCARE
MI
01
—
1150900464
HEALTH PLUS OF MI
MI
01
—
16613
COMMUNITY CHOICE
MI
01
—
28233
PRIORITY HEALTH
MI
05
—
4164290
—
MI
01
—
4220040
AETNA
MI
01
—
50900464
BLUE CARE NETWORK
MI
Enumeration date
08/30/2006
Last updated
11/19/2014
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