Ketelaar, Michael
Ketelaar, Michael is an sole proprietor health care provider with primary practice located at 1231 W Vine St , Lodi CA 95240-5109. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Ketelaar, Michael can be contacted via phone (209) 368-7121.Contact Information
Primary practice address
1231 W Vine St
Lodi CA 95240-5109
Phone: (209) 368-7121
Fax: (209) 368-5750
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | C39467 | California |
Profile Details
| NPI number | 1487705935 |
|---|---|
| LBN Legal business name | Ketelaar, Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 12th, 2007 |
| Last updated | Jun 17th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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