MARK W. KETTERER PH.D. – NPI #1285782870
Psychiatry & Neurology
Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS).
MARK KETTERER is a psychiatry & neurologist located in DETROIT, MI. NPPES has assigned the NPI number 1285782870 to MARK KETTERER on January 08, 2007. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 2084N0600X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Clinical Neurophysiology
The NPI profile was previously updated about 19 years ago on Jul 08, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MARK KETTERER below.
NPI Profile for
MARK W. KETTERER
(more than 19 years ago)
2799 WEST GRAND BOULEVARD
DETROIT, MI 48202 Phone: (313) 916-2436 Fax:
Identifiers for MARK KETTERER
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| OTHER | CHAMPUS-CHAMPUS | MK007377 | |
| OTHER | COMMERCIAL-COMMERCIAL NUMBER | MK007377 | |
| MEDICAID | MI | PHD888810 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 2084N0600X - Psychiatry & Neurology / Clinical Neurophysiology (Primary) |
MI | 6301007377 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.