1699802660 NPI number — DR. EILEEN M. MCKEE PHD

Table of content: DR. EILEEN M. MCKEE PHD (NPI 1699802660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699802660 NPI number — DR. EILEEN M. MCKEE PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCKEE
Provider First Name:
EILEEN
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699802660
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 HURLEY PLZ
Provider Second Line Business Mailing Address:
5TH FLOOR S.O.N.
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48503-5902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-762-7038
Provider Business Mailing Address Fax Number:
810-760-0440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
G-1125 S. LINDEN ROAD
Provider Second Line Business Practice Location Address:
SUITE #210
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-230-3370
Provider Business Practice Location Address Fax Number:
810-230-3376
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC2200X , with the licence number:  6301008391 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0B51092 . This is a "BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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