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General NPI Number Information
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NPI Number | 1235390402
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Entity Type | Organization
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Legal Business Name | GERALD D KEYTE DO PC
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 35324 COLLEGE
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City | WESTLAND
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State | MI
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Zip | 48185
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Country | US
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Telephone | 734-721-2769
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Fax | 734-721-7839
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Provider Business Mailing Address
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Address Line | 35324 COLLEGE
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City | WESTLAND
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State | MI
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Zip | 48185
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Country | US
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Telephone | 734-721-2769
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Fax | 734-721-7839
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERALD D KEYTE
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Credential | DO
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Telephone | 734-721-2769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 5101004817
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License Number State | MI
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