| Doctor Name: | MR. JOHN KETA |
| NPI Number: | 1144245804 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 002242 |
| Business Practice Address: | 50505 Schoenherr Rd Suite 290 Shelby Twp, MI - 483153140 |
| Business Phone Number: | 5863140054 |
| Business Fax Number: | 5867316275 |
| Mailing Address: | 50505 Schoenherr Rd, Suite 290 SHELBY TWP |
| State: | MI |
| Postal Code: | 483153140 |
| Phone Number: | 5863140054 |
| Fax Number: | 5867316275 |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 03/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 002242 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |