Provider Demographics
NPI:1790819399
Name:KRISTIN KESKEY MD, PC.
Entity Type:Organization
Organization Name:KRISTIN KESKEY MD, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-745-5600
Mailing Address - Street 1:2520 S TELEGRAPH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0202
Mailing Address - Country:US
Mailing Address - Phone:248-745-5600
Mailing Address - Fax:248-745-8839
Practice Address - Street 1:2520 S TELEGRAPH RD STE 101
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0202
Practice Address - Country:US
Practice Address - Phone:248-745-5600
Practice Address - Fax:248-745-8839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M82770Medicare PIN