MEDICARE: KAREL A KEITER DO

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
1	207Q00000X	Family Medicine Physician	OS006867L	PA
2	207QB0002X	Obesity Medicine (Family Medicine) Physician	OS006867L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396702197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREL A KEITER DO

Provider Business Mailing Address
First Line	:	875 SOUTH ARLINGTON AVE
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-5036
Country	:	US
Telephone Number	:	717-652-1107
Fax Number	:	717-652-1142

Provider Business Practice Location Address
First Line	:	4315 LONDONDERRY ROAD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-5036
Country	:	US
Telephone Number	:	717-909-0290
Fax Number	:	717-909-0292

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	12/15/2015

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Directions to “ KAREL A KEITER DO” Practice Location

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