MEDICARE: KRISTIN KESKEY MD PC

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	207R00000X	Internal Medicine Physician	KK038005	MI

General Provider Information

NPI Number	:	1679573349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTIN KESKEY MD PC

Provider Business Mailing Address
First Line	:	2520 S TELEGRAPH RD
Second Line	:	SUITE 101
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0285
Country	:	US
Telephone Number	:	248-745-5600
Fax Number	:	248-745-8839

Provider Business Practice Location Address
First Line	:	2520 S TELEGRAPH RD
Second Line	:	SUITE 101
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0285
Country	:	US
Telephone Number	:	248-745-5600
Fax Number	:	248-745-8839

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KRISTIN A KESKEY
Credential	:	MD
Telephone Number	:	248-745-5600

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	08/22/2020

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