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NPI Code Detail

MEDICARE: APRIL R ST JOHN-KEENOY DO

MEDICARE: APRIL R ST JOHN-KEENOY DO
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
1208D00000XGeneral Practice Physician5101015757MI
2207Q00000XFamily Medicine Physician5101015757MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15101015757OTHERMISTATE LICENSE NUMBER

General Provider Information

NPI Number : 1902971641
Entity Type Code : Individual
Provider Name (Legal Business Name) : APRIL R ST JOHN-KEENOY DO
Provider Business Mailing Address
First Line : PO BOX 1239
Second Line :
City : TROY
State : MI
Zip : 48099-1239
Country : US
Telephone Number : 248-824-6600
Fax Number : 855-618-6655
Provider Business Practice Location Address
First Line : 1484 STRAITS DR STE 5
Second Line :
City : BAY CITY
State : MI
Zip : 48706-8718
Country : US
Telephone Number : 989-667-8740
Fax Number : 989-667-8745
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 06/10/2013

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Directions to “ APRIL R ST JOHN-KEENOY DO” Practice Location

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