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General NPI Number Information
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NPI Number | 1851338537
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Entity Type | Organization
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Legal Business Name | KEITH F. KORVER, M.D., INC.
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 719 SOUTHPOINT BLVD STE B
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City | PETALUMA
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State | CA
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Zip | 94954-8003
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Country | US
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Telephone | 707-778-8421
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Fax | 707-778-1702
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Provider Business Mailing Address
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Address Line | 3510 UNOCAL PL STE 207
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City | SANTA ROSA
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State | CA
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Zip | 95403-0918
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Country | US
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Telephone | 707-569-7860
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Fax | 707-545-5408
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEITH FORREST KORVER
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Credential | M.D.
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Telephone | 707-569-7860
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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