MEDICARE: MS. MARIA KEEVER MMSC

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	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1861943920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA KEEVER MMSC

Provider Business Mailing Address
First Line	:	8005 FALLING LEAF CT
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-5111
Country	:	US
Telephone Number	:	919-345-6106
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 NEW BERN AVE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-1215
Country	:	US
Telephone Number	:	919-350-8982
Fax Number	:

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

Provider Enumeration Date	:	10/24/2016
Last Update Date	:	10/24/2016

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