Individual
DR. KEITH CRESWELL MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15501 METROPOLITAN PKWY, STE 110, CLINTON TWP, MI 48036-1684
(586) 286-9720
(586) 286-3134
Mailing address
15501 METROPOLITAN PKWY, STE 110, CLINTON TWP, MI 48036-1684
(586) 286-9720
(586) 286-3134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301067883
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0805013811
BCBSM OF MICHIGAN
MI
01
—
352206784
TAX ID
MI
Enumeration date
06/15/2006
Last updated
01/15/2018
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