Healthcare Provider Details

I. General information

NPI: 1578521894
Provider Name (Legal Business Name): MICHAEL M MCKEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 DEXTER ANN ARBOR RD
DEXTER MI
48130-8598
US

IV. Provider business mailing address

3621 SOUTH STATE ST 700 KMS PLACE
ANN ARBOR MI
48108
US

V. Phone/Fax

Practice location:
  • Phone: 734-426-2796
  • Fax: 734-426-4370
Mailing address:
  • Phone: 734-936-2047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number232621
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301104183
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: