Healthcare Provider Details

I. General information

NPI: 1023690583
Provider Name (Legal Business Name): EVAN S KELLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2021
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 OHARA ST STE 431
PITTSBURGH PA
15213-2561
US

IV. Provider business mailing address

2 ALLEGHENY CTR STE 530
PITTSBURGH PA
15212-5404
US

V. Phone/Fax

Practice location:
  • Phone: 412-246-5320
  • Fax:
Mailing address:
  • Phone: 412-330-5851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD489622
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD489622
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD489622
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: