Individual
KEITH ANDREW CASPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DRIVE, 1ST FLOOR TAUBMAN CTR RECP A, ANN ARBOR, MI 48109-5312
(734) 936-8051
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35093032
OH
207Y00000X
Otolaryngology Physician
4301091474
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200954230
—
IN
05
—
2956556
—
OH
01
—
4267123
MEDICARE PTAN
OH
05
—
7100080700
—
KY
Enumeration date
05/25/2007
Last updated
07/17/2015
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