Provider Demographics
NPI:1578521894
Name:MCKEE, MICHAEL M (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:MCKEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 SOUTH STATE ST
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:7300 DEXTER ANN ARBOR RD
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-8598
Practice Address - Country:US
Practice Address - Phone:734-426-2796
Practice Address - Fax:734-426-4370
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY232621207Q00000X
MI4301104183207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY051004000075OtherFIDELIS
NY00027337601OtherUNIVERA
NY0113858OtherIHA
NY11199151OtherCAQH
NYP010232621OtherBLUE CHOICE
NY00355266Medicaid
NY141287BFOtherPREFERRED CARE
NY5884OtherSIDNEY HILLMAN
I13101Medicare UPIN
NY0113858OtherIHA