DR. KEITH CRESWELL MCKENZIE (NPI# 1801830757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801830757 |
| Entity Type | Individual |
| Full Name | DR. KEITH CRESWELL MCKENZIE |
| Credential | M.D. |
| Practice Address |
15501 Metropolitan Pkwy Ste 110 Clinton Twp MI 48036-1684 |
| Practice Telephone | 5862869720 |
| Practice Fax Number | 5862863134 |
| Mailing Telephone | 5862869720 |
| Mailing Fax Number | 5862863134 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2018-01-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301067883 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM OF MICHIGAN | 0805013811 | 01 |
| MI | TAX ID | 352206784 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003215740 | Keith Mckenzie | Counselor | 332 W Broadway Ste 905, Louisville, KY 40202-2133 | 2014-08-19 |
| Street Address |
15501 METROPOLITAN PKWY STE 110 |
| City | CLINTON TWP |
| State | MI |
| Zip Code | 48036-1684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700827813 | Robert H Amsler | Specialist | 15501 Metropolitan Pkwy, Ste 110, Clinton Twp, MI 48036-1684 | 2006-06-09 |
| 1922337815 | Mary E. Nasir | Physical Therapy Assistant | 15501 Metropolitan Pkwy, Suite 102, Clinton Twp, MI 48036-1684 | 2009-12-23 |
| 1770733867 | Michael Arthur Merz | Psychologist | 15501 Metropolitan Pkwy, Suite107, Clinton Twp, MI 48036-1684 | 2008-09-24 |
| 1801084629 | Keith C Mckenzie Md Pllc | Family Medicine | 15501 Metropolitan Pkwy, Suite 110, Clinton Twp, MI 48036-1684 | 2007-10-05 |
| 1801975420 | Charlene Bailey | Physician Assistant | 15501 Metropolitan Pkwy, Ste110, Clinton Twp, MI 48036-1684 | 2006-11-03 |
| 1548347230 | Physical Therapy & Pain Clinic,inc | Specialist | 15501 Metropolitan Pkwy, Suite 102, Clinton Twp, MI 48036-1684 | 2006-11-01 |
| 1861597858 | Claudia Monica Pop | Family Medicine | 15501 Metropolitan Pkwy, Ste 110, Clinton Twp, MI 48036-1684 | 2006-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043728918 | Joseph John Memminger IIi | Pathology | 23885 Denton St Ste B, Clinton Township, MI 48036 | 2018-01-13 |
| 1124563267 | Melinda Fiends | Social Worker | 42950 Stepnitz, Clinton Township, MI 48036 | 2016-12-28 |
| 1689119729 | The Salvation Army Harbor Light Macomb | Substance Abuse Rehabilitation Facility | 42950 Stepnitz Drive, Clinton Township, MI 48036 | 2016-12-28 |
| 1639573033 | Mycare Health Center | Clinic/Center | 43740 Groesbeck, Clinton Township, MI 48036 | 2014-10-14 |
| 1427368992 | Prestigious Transportation | Non-emergency Medical Transport (VAN) | 22931 N.nunneley Apt. 203, Clinton Township, MI 48036 | 2010-10-18 |
| 1649413436 | Robert B Hengehold | Pharmacist | 37165 Groesbeck Hwy., Clinton Twp., MI 48036 | 2009-04-09 |
| 1548408461 | Rodolfo Sia Yapchai | Internal Medicine | 37900 Saddle Lane, Clinton Twp, MI 48036 | 2009-01-30 |
| 1811135775 | Anthony Frank Balcerzak | Rehabilitation Counselor | 38516 N Gratiot Avenue, Clinton Twp, MI 48036 | 2009-01-30 |
| 1508034661 | Laurie J Church | Counselor | 22800 Hall Rd Ste 240, Clinton Township, MI 48036 | 2008-02-12 |
| 1912128182 | Phyllis Ann Billings-mcneil | Social Worker | 38251 Groesbeck Highway, Clinton Twp, MI 48036 | 2007-05-02 |
| Find all providers in zip 48036 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073776456 | Reynold M John, Md, PC | Family Medicine | 43171 Dalcoma Dr Ste 6, Clinton Twp, MI 48038-6307 | 2008-07-07 |
| 1205840691 | Iris Bourbon Daniel | Family Medicine | 42490 Garfield, Suite 207, Clinton Twp, MI 48038 | 2006-07-28 |
| 1093767683 | Thao Phuong Pham | Family Medicine | 15717 15 Mile Rd, Clinton Twp, MI 48035-2101 | 2006-05-16 |
| 1265482095 | Mark Robert Kurzawa | Family Medicine | 36367 Harper Ave, Clinton Twp, MI 48035-2958 | 2006-05-11 |
| 1013988773 | Albert Anthony Przybylski | Family Medicine | 36549 Harper Ave, Suite B, Clinton Twp, MI 48035-2012 | 2006-01-31 |
| 1619956497 | John R Pradko | Family Medicine | 33720 Harper Ave, Suite A, Clinton Twp, MI 48035 | 2006-01-11 |
| 1336130632 | Charles E Heth | Family Medicine | 42855 Garfield Rd, Ste 105, Clinton Twp, MI 48038-5027 | 2005-11-04 |
| 1417946815 | Paul Richard Gradolph | Family Medicine | 43421 Garfield Rd, Ste 1, Clinton Twp, MI 48038-1133 | 2005-10-18 |
| 1346240124 | Cynthia Marie Trosin | Family Medicine | 35103 Silvano St, Clinton Twp, MI 48035-2685 | 2005-07-22 |
| 1174521207 | Pamela Rae Valka | Family Medicine | 37399 Garfield, Suite 203, Clinton Twp, MI 48036-3659 | 2005-07-12 |
| Find all providers in CLINTON TWP | ||||
| City | CLINTON TWP |
| Zip Code | 48036 |
Please comment or provide details below to improve the information on DR. KEITH CRESWELL MCKENZIE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.