Individual
PHADEJ KEOPUNNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
70 NORTH FROST DR, SAGINAW, MI 48638
(989) 792-6776
(989) 792-6792
Mailing address
70 NORTH FROST DRIVE, SAGINAW, MI 48638
(989) 792-6776
(989) 792-6792
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
PK035585
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2105487
—
MI
Enumeration date
09/20/2006
Last updated
07/08/2007
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