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General NPI Number Information
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NPI Number | 1104022565
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Entity Type | Individual
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Provider Name | SARA C KELLER MD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 10751 FALLS RD SUITE 412
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City | LUTHERVILLE
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State | MD
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Zip | 21093-4517
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Country | US
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Telephone | 410-583-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-6423
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 22260
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MD441311
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | D76158
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License Number State | MD
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