MEDICARE: KEITH ANDREW KOBET M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	4301038029	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2332414001	OTHER	MI	CIGNA
2	4066601	OTHER	MI	AETNA
3	527736	OTHER	MI	ONE HEALTH PLAN
4	028206	OTHER	MI	MIDWEST HEALTH
5	15474	OTHER	MI	SPECTERA
6	B4520	OTHER	MI	MCARE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	P48542	OTHER	MI	BLUECARE NETWORK
10	1808221261	OTHER	MI	BLUE CROSS AND BLUE SHIEL
11	102424	OTHER	MI	CARE CHOICES
12	KK038029	OTHER	MI	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1588667752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH ANDREW KOBET M.D.

Provider Business Mailing Address
First Line	:	7949 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-1533
Country	:	US
Telephone Number	:	734-459-7850
Fax Number	:	734-459-5799

Provider Business Practice Location Address
First Line	:	7949 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-1533
Country	:	US
Telephone Number	:	734-459-7850
Fax Number	:	734-459-5799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/18/2011

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