NPIMap

Organization Active NPI

Marc E Keen, M.D. P.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Ludington, MI
National Provider Identifier
1528014693
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301057451 Issued in MI
Legal business name
MARC E KEEN, M.D. P.C.
Practice address
1 N Atkinson Dr
Ludington, MI 49431-1906
Phone
(231) 845-2362
Fax
(231) 845-2440
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Marc Elwin Keen, M.D.
Title
Owner
Phone
(231) 845-2362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 4301057451 MI Primary

Addresses

Primary practice location

1 N Atkinson Dr
Ludington, MI 49431-1906

Mailing address

1 N Atkinson Dr
Ludington, MI 49431-1906
Phone (231) 845-2362

Other identifiers 3

IdentifierTypeStateIssuer
DG1399OtherMIMEDICARE RAILROAD
2205330071OtherMIBCBSMI PATHOLOGY PIN
2773078MedicaidMI

Other names 1

  • PATHOLOGY SERVICES OF WEST MI Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1528014693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N ATKINSON DR",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311906",
            "telephone_number": "231-845-2362",
            "fax_number": "231-845-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N ATKINSON DR",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311906",
            "telephone_number": "231-845-2362",
            "fax_number": "231-845-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC E KEEN, M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "KEEN",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "ELWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-845-2362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301057451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DG1399",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMI PATHOLOGY PIN",
            "identifier": "2205330071",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2773078",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHOLOGY SERVICES OF WEST MI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.