Provider Demographics
NPI:1588667752
Name:KOBET, KEITH ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:ANDREW
Last Name:KOBET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7949 N CANTON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1533
Mailing Address - Country:US
Mailing Address - Phone:734-459-7850
Mailing Address - Fax:734-459-5799
Practice Address - Street 1:7949 N CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1533
Practice Address - Country:US
Practice Address - Phone:734-459-7850
Practice Address - Fax:734-459-5799
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2011-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301038029207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2332414001OtherCIGNA
MI4066601OtherAETNA
MI527736OtherONE HEALTH PLAN
MI028206OtherMIDWEST HEALTH
MI15474OtherSPECTERA
MIB4520OtherMCARE
MI2108685Medicaid
MI000000002931OtherCAPE MEDICAID
MIP48542OtherBLUECARE NETWORK
MI1808221261OtherBLUE CROSS AND BLUE SHIEL
MI102424OtherCARE CHOICES
MIKK038029OtherSTATE LICENSE NUMBER
MIB47398Medicare UPIN
MIP48542OtherBLUECARE NETWORK
MI527736OtherONE HEALTH PLAN