Individual
DR. KEITH N MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3272 E. 12 MILE ROAD, SUITE 102, WARREN, MI 48092
(586) 558-9360
(586) 573-3130
Mailing address
3272 E. 12 MILE ROAD, SUITE 102, WARREN, MI 48092
(586) 558-9360
(586) 573-3130
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
KM007974
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4508283
—
MI
Enumeration date
09/29/2006
Last updated
07/08/2007
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