MEDICARE: ROBERT JOSEPH KEATING 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	207Q00000X	Family Medicine Physician	35-06-0778	OH

General Provider Information

NPI Number	:	1790851558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JOSEPH KEATING MD

Provider Business Mailing Address
First Line	:	18820 BAGLEY RD
Second Line	:	#102
City	:	CLEVELAND
State	:	OH
Zip	:	44130-3325
Country	:	US
Telephone Number	:	440-973-4427
Fax Number	:	440-973-4428

Provider Business Practice Location Address
First Line	:	18820 BAGLEY RD
Second Line	:	#102
City	:	CLEVELAND
State	:	OH
Zip	:	44130-3325
Country	:	US
Telephone Number	:	440-973-4427
Fax Number	:	440-973-4428

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

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	01/19/2016

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