MEDICARE: KEITH A KREITZ 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	208600000X	Surgery Physician	MD430162	PA
2	208600000X	Surgery Physician	15775R	LA
3	208600000X	Surgery Physician	2023-02847	NC

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	7933617	OTHER	PA	AETNA
3	1901798	OTHER	PA	HIGHMARK BLUE SHIELD
4	2768753000	OTHER	PA	KEYSTONE IBC
5	30211403	OTHER	PA	KEYSTONE FIRST
6	P01468758	OTHER	PA	RAILROAD MEDICINE
7	5300345	OTHER	PA	CIGNA PA
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336101591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH A KREITZ MD

Provider Business Mailing Address
First Line	:	211 DUPLIN STREET
Second Line	:
City	:	KENANSVILLE
State	:	NC
Zip	:	28341-9024
Country	:	US
Telephone Number	:	910-275-0027
Fax Number	:	910-296-0214

Provider Business Practice Location Address
First Line	:	211 DUPLIN STREET
Second Line	:
City	:	KENANSVILLE
State	:	NC
Zip	:	28349-9024
Country	:	US
Telephone Number	:	910-275-0027
Fax Number	:	910-296-0214

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	12/04/2023

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Directions to “ KEITH A KREITZ MD” Practice Location

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