Provider Demographics
NPI:1790754521
Name:KESKIN, ADIL (MD)
Entity Type:Individual
Prefix:
First Name:ADIL
Middle Name:
Last Name:KESKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5545
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47903-5545
Mailing Address - Country:US
Mailing Address - Phone:765-448-8000
Mailing Address - Fax:
Practice Address - Street 1:1234 NAPIER AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2112
Practice Address - Country:US
Practice Address - Phone:269-983-8172
Practice Address - Fax:269-985-4535
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060548A207RP1001X, 207RC0200X
MI4301501242207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN11469401OtherCAQH NUMBER
IN200513680Medicaid
IN9397210OtherPHCS PID NUMBER
IN000000363430OtherANTHEM PROVIDER NUMBER
INI28774Medicare UPIN
IN9397210OtherPHCS PID NUMBER
IN815490KKKMedicare PIN
INP00234730Medicare PIN
IN815450YMedicare PIN
IN224390PMedicare PIN