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Donald J Kettinger

  • Male

Medical Specialty

Professional ID

  • NPI: 1548233273
  • PECOS ID: 9739198094
  • Enrollment ID: I20060413000475
  • Credential(MD, DO, DPM): CNA
  • Medical School:
  • Medical School Graduation Year: 1988

Hospital Service

  • Hospital CCN1: 230099
  • Business Name (LBN)1: Promedica Monroe Regional Hospital
  • Hospital CCN2: 230031
  • Business Name (LBN)2: Lake Huron Medical Center

Medical Practices

  • Organization Name: Prime Healthcare Services Port Huron Llc
  • Group Practice ID assigned by PECOS: 7214245208
  • Number of Group Practice member: 16

Location

  • Address1: 2601 Electric Ave
  • Address2: Lake Huron Medical Center
  • City: Port Huron
  • State: Michigan
  • Zip Code: 48060
  • Phone Number: (810)985-1500

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS):
  • Used Electronic health record (EHR):