Provider Demographics
NPI:1295911253
Name:STEVEN L KEYTE DPM PC
Entity type:Organization
Organization Name:STEVEN L KEYTE DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KEYTE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:269-342-0201
Mailing Address - Street 1:4415 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-3224
Mailing Address - Country:US
Mailing Address - Phone:269-342-0201
Mailing Address - Fax:269-342-2374
Practice Address - Street 1:4415 DUKE ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3224
Practice Address - Country:US
Practice Address - Phone:269-342-0201
Practice Address - Fax:269-342-2374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-21
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901400119213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2895455Medicaid
MI0137090001Medicare NSC
MIT33993Medicare UPIN
MI5395008Medicare PIN