Individual
DR. KEITH W CHRISTMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1627 W BIG BEAVER RD, TROY, MI 48084-3501
(248) 220-1560
(248) 220-1563
Mailing address
585 SOUTH BLVD E STE 100, PONTIAC, MI 48341-3163
(248) 206-1200
(248) 206-1206
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
KC067976
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080189691
RAILROAD MEDICARE
MI
01
—
0806334351
BCBS BCN
MI
01
—
0806366101
BCN
MI
05
—
4469855
—
MI
Enumeration date
07/14/2005
Last updated
04/14/2020
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