Individual
CAROLYN J KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4100 PARK FOREST DR, SUITE 210, TRAVERSE CITY, MI 49684-7331
(231) 935-5770
(231) 935-0747
Mailing address
4100 PARK FOREST DR, SUITE 210, TRAVERSE CITY, MI 49684-7331
(231) 935-5770
(231) 935-0747
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301048726
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851380497
—
MI
Enumeration date
10/17/2005
Last updated
04/10/2015
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