MEDICARE: MARIA A KELLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	10633	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144291709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA A KELLER MD

Provider Business Mailing Address
First Line	:	2505 ANTHEM VILLAGE DR STE E-246
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-5505
Country	:	US
Telephone Number	:	702-671-0006
Fax Number	:	702-252-3000

Provider Business Practice Location Address
First Line	:	8605 S EASTERN AVE
Second Line	:	STE C
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2869
Country	:	US
Telephone Number	:	702-671-0006
Fax Number	:	702-671-0006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	07/24/2017

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Directions to “ MARIA A KELLER MD” Practice Location

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