Individual
ROBERT STEVEN KETAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
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
—
1018770
—
MI
01
—
20721
OMNICARE (HMO)
MI
01
—
540F340180
BCBSM DME
MI
01
—
5635300
BLUE CROSS/BLUE SHIELD MI
MI
01
—
80721
OMNICARE (POS)
MI
01
—
P76006
BLUE CARE NETWORK
MI
01
—
RK000588
LICENSE NUMBER
MI
Enumeration date
01/27/2006
Last updated
09/24/2008
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