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General NPI Number Information
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NPI Number | 1841975828
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Entity Type | Individual
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Provider Name | KEITH SAMUEL MCARTHUR
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Gender | Male
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 3901 BEAUBIEN ST
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City | DETROIT
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State | MI
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Zip | 48201-2196
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Country | US
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Telephone | 313-745-5538
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 BEAUBIEN 4TH FLOOR CARL'S BLDG. CARDIOVASCULAR SURGERY
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | 4704310778
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License Number State | MI
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