Healthcare Provider Details

I. General information

NPI: 1679575609
Provider Name (Legal Business Name): RAY F. KEATE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 04/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8262 ATLEE RD SUITE 202
MECHANICSVILLE VA
23116-1816
US

IV. Provider business mailing address

107 WADSWORTH DR
NORTH CHESTERFIELD VA
23236-4521
US

V. Phone/Fax

Practice location:
  • Phone: 804-559-6194
  • Fax: 804-559-6197
Mailing address:
  • Phone: 804-330-4901
  • Fax: 804-330-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101233679
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: