Provider Demographics
NPI:1790948834
Name:MIYAZAKI, KEI (MD)
Entity Type:Individual
Prefix:DR
First Name:KEI
Middle Name:
Last Name:MIYAZAKI
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 1:1500 E MEDICAL CENTER DR
Mailing Address - Street 2:L2003 WOMEN'S HOSPITAL, SPC 5239
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5000
Mailing Address - Country:US
Mailing Address - Phone:734-615-2690
Mailing Address - Fax:734-615-2687
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:L2003 WOMEN'S HOSPITAL, SPC 5239
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-615-2690
Practice Address - Fax:734-615-2687
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program