Provider Demographics
NPI:1477562270
Name:CURTIS, KEITH L (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:L
Last Name:CURTIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18181 OAKWOOD BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-5032
Mailing Address - Country:US
Mailing Address - Phone:313-593-1041
Mailing Address - Fax:313-240-7093
Practice Address - Street 1:18181 OAKWOOD BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-5032
Practice Address - Country:US
Practice Address - Phone:313-593-1041
Practice Address - Fax:313-240-7093
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301025238207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA74261Medicare UPIN