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General NPI Number Information
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NPI Number | 1316261290
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Entity Type | Individual
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Provider Name | ANDREW M KELLER MD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2010
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 8050 E MAIN ST STE 3100
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-1246
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Country | US
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Telephone | 614-866-8077
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Fax | 614-866-9752
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Provider Business Mailing Address
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Address Line | 8050 E MAIN ST STE 3100
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-1246
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Country | US
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Telephone | 614-866-8077
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Fax | 614-866-9752
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35.099041
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License Number State | OH
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