Individual provider · Type 1 NPI

Kenneth Grant Masters, DO

Student in an Organized Health Care Education/Training Program · Detroit, MI

NPI number 1295355063 Active

Practice location

4201 Saint Antoine St
Detroit, MI 48201-2153

Call (313) 745-3000 Map

Mailing address

3990 John R St # 162
Detroit, MI 48201-2018

Other practice locations

  • 10000 Telegraph Rd, Taylor, MI 48180-3330 · (313) 295-5000

Specialties and licenses

TaxonomyCodeLicense
Anesthesiology Physician 207L00000X5101027678 (MI)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1295355063

Kenneth Grant Masters, DO's National Provider Identifier is 1295355063, issued on Apr 22, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Detroit, MI. The record was last updated on Aug 5, 2025.