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General NPI Number Information
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NPI Number | 1528014693
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Entity Type | Organization
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Legal Business Name | MARC E KEEN, M.D. P.C.
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 01/15/2008
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Provider Practice Location Address
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Address Line | 1 N ATKINSON DR
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City | LUDINGTON
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State | MI
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Zip | 49431-1906
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Country | US
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Telephone | 231-845-2362
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Fax | 231-845-2440
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Provider Business Mailing Address
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Address Line | 1 N ATKINSON DR
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City | LUDINGTON
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State | MI
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Zip | 49431-1906
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Country | US
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Telephone | 231-845-2362
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Fax | 231-845-2440
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARC ELWIN KEEN
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Credential | M.D.
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Telephone | 231-845-2362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 4301057451
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License Number State | MI
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