Individual
KEITH M STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
44199 DEQUINDRE RD, SUITE 311, TROY, MI 48085-1128
(248) 964-9490
(248) 964-9470
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
4301009404
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E00425
BLUE CROSS OF MICHIGAN
MI
05
—
2693478
—
MI
01
—
290F34972
BLUE CROSS OF MICHIGAN
MI
Enumeration date
07/12/2006
Last updated
10/23/2020
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