Keith Brian Tom (NPI# 1609850130, PAC ID# 1052378676) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1609850130 |
| PAC ID by PECOS | 1052378676 |
| Professional Enrollment ID | I20041215000775 |
| Full Name | Keith Brian Tom |
| Address |
49221 Van Dyke Ave Shelby Township MI 48317-1336 |
| Gender | M |
| Credential | DO |
| Medical School | MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1985 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230130 | BEAUMONT HOSPITAL, ROYAL OAK |
| 230269 | BEAUMONT HOSPITAL, TROY |
| Address | Phone | Organization |
|---|---|---|
| 49221 Van Dyke Ave, Shelby Township, MI 48317-1336 |
| Street Address |
49221 VAN DYKE AVE |
| City | SHELBY TOWNSHIP |
| State | MI |
| Zip | 48317-1336 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chad R Stencel | Family Medicine | Alliance Health Professionals Pllc | 49310 Van Dyke Ave, Shelby Township, MI 48317-1337 |
| Jessica Elizabeth Krol | Family Medicine | Alliance Health Professionals Pllc | 49310 Van Dyke Ave, Shelby Township, MI 48317-1337 |
| Robert W Diegel | Chiropractic | 49780 Van Dyke Ave, Shelby Township, MI 48317-1343 | |
| Melissa S Carafelli | Nurse Practitioner | Crossing Paths, P.C. | 50258 Van Dyke Ave, Suite A, Shelby Township, MI 48317-1374 |
| Kelly M Danielson | Clinical Social Worker | Crossing Paths, P.C. | 50258 Van Dyke Ave, Suite A, Shelby Township, MI 48317-1374 |
| Sarah Mitchell | Clinical Social Worker | Crossing Paths, P.C. | 50258 Van Dyke Ave, Suite A, Shelby Township, MI 48317-1374 |
| Tynise L Penn | Nurse Practitioner | Crossing Paths, P.C. | 50258 Van Dyke Ave, Suite A, Shelby Township, MI 48317-1374 |
| Scott Gordon Mcleod | Chiropractic | 48073 Van Dyke Ave, Shelby Township, MI 48317-3258 | |
| Danna Haba | Optometry | 48189 Van Dyke Ave, Shelby Township, MI 48317-3268 | |
| Keith J Guthrie | Chiropractic | 8187 Rhode Dr A, Shelby Township, MI 48317-3279 | |
| Find all physicians in zip 48317 | |||
| City | SHELBY TOWNSHIP |
| Zip Code | 48317 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | SHELBY TOWNSHIP + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.