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General NPI Number Information
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NPI Number | 1588778344
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Entity Type | Individual
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Provider Name | KEITH CHARLES CARVER D.M.D., M.D., M.S.
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 395 W 12TH AVE ROOM 460
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City | COLUMBUS
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State | OH
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Zip | 43210-1267
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Country | US
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Telephone | 614-293-6935
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Fax |
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Provider Business Mailing Address
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Address Line | 395 W 12TH AVE ROOM 460
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City | COLUMBUS
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State | OH
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Zip | 43210-1267
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Country | US
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Telephone | 614-293-6935
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 3962
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35.131775
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License Number State | OH
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