Healthcare Provider Details

I. General information

NPI: 1174578116
Provider Name (Legal Business Name): E CHRISTINE KEATING DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 S 16TH STREET SUITE #1020
MILWAUKEE WI
53215
US

IV. Provider business mailing address

3201 S 16TH ST #1020
MILWAUKEE WI
53215-4537
US

V. Phone/Fax

Practice location:
  • Phone: 414-643-7337
  • Fax: 414-643-1766
Mailing address:
  • Phone: 414-365-3210
  • Fax: 414-365-2937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24155 WI
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: