Provider Demographics
NPI:1679573349
Name:KRISTIN KESKEY MD PC
Entity type:Organization
Organization Name:KRISTIN KESKEY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-745-5600
Mailing Address - Street 1:2520 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0285
Mailing Address - Country:US
Mailing Address - Phone:248-745-5600
Mailing Address - Fax:248-745-8839
Practice Address - Street 1:2520 S TELEGRAPH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0285
Practice Address - Country:US
Practice Address - Phone:248-745-5600
Practice Address - Fax:248-745-8839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKK038005207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty