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NPI Code Detail

MEDICARE: DR. TODD ALAN KELLER M.D.

MEDICARE: DR. TODD ALAN KELLER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician35-079615OH

General Provider Information

NPI Number : 1083924526
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD ALAN KELLER M.D.
Provider Business Mailing Address
First Line : 9 EAGLE CREEK DR
Second Line :
City : NORWALK
State : OH
Zip : 44857-8849
Country : US
Telephone Number : 419-668-6610
Fax Number : 419-668-6610
Provider Business Practice Location Address
First Line : 1200 SYCAMORE LINE
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-4029
Country : US
Telephone Number : 419-668-6610
Fax Number : 419-668-6610
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2010
Last Update Date : 10/18/2010

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