Individual
RUSSELL D KEINATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5300 ELLIOTT DR, YPSILANTI, MI 48197-8632
(734) 434-6262
(734) 712-2820
Mailing address
5300 ELLIOTT DR, YPSILANTI, MI 48197-8632
(734) 434-6262
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301043636
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021534
MIDWEST HEALTH PLAN
MI
01
—
0H14989
BCBSM GROUP
MI
05
—
1728793
—
MI
01
—
2403058001
CIGNA
MI
01
—
4404030
AETNA
MI
Enumeration date
01/13/2006
Last updated
01/12/2018
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