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General NPI Number Information
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NPI Number | 1336101591
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Entity Type | Individual
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Provider Name | KEITH A KREITZ MD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 211 DUPLIN STREET
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City | KENANSVILLE
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State | NC
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Zip | 28349-9024
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Country | US
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Telephone | 910-275-0027
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Fax | 910-296-0214
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Provider Business Mailing Address
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Address Line | 211 DUPLIN STREET
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City | KENANSVILLE
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State | NC
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Zip | 28341-9024
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Country | US
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Telephone | 910-275-0027
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Fax | 910-296-0214
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD430162
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 15775R
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2023-02847
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License Number State | NC
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