MEDICARE: E CHRISTINE KEATING DO

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	208000000X	Pediatrics Physician	24155 WI	WI

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

General Provider Information

NPI Number	:	1174578116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	E CHRISTINE KEATING DO

Provider Business Mailing Address
First Line	:	3201 S 16TH ST
Second Line	:	#1020
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-4537
Country	:	US
Telephone Number	:	414-365-3210
Fax Number	:	414-365-2937

Provider Business Practice Location Address
First Line	:	3201 S 16TH STREET
Second Line	:	SUITE #1020
City	:	MILWAUKEE
State	:	WI
Zip	:	53215
Country	:	US
Telephone Number	:	414-643-7337
Fax Number	:	414-643-1766

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	04/19/2017

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