MEDICARE: KEITH A. KOBET, M.D., P.C.

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	207W00000X	Ophthalmology Physician	4301038029	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G5034F	OTHER	MI	BLUECARE NETWORK GROUP NO

General Provider Information

NPI Number	:	1750385506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEITH A. KOBET, M.D., P.C.

Provider Business Mailing Address
First Line	:	7949 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-1533
Country	:	US
Telephone Number	:	734-459-7850
Fax Number	:	734-459-5799

Provider Business Practice Location Address
First Line	:	7949 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-1533
Country	:	US
Telephone Number	:	734-459-7850
Fax Number	:	734-459-5799

Authorized Official
Title or Position	:	OWNER
Name	:	KEITH A KOBET
Credential	:	M.D.
Telephone Number	:	734-459-7850

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	08/22/2020

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