MEDICARE: ELIZABETH KEISER MD, MPH

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	207ZD0900X	Dermatopathology (Pathology) Physician	9271180	ID
2	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	MD61056579	WA
3	207ZD0900X	Dermatopathology (Pathology) Physician	A146294	CA
4	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	A146294	CA
5	207ZD0900X	Dermatopathology (Pathology) Physician	61056579	WA

General Provider Information

NPI Number	:	1942696711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH KEISER MD, MPH

Provider Business Mailing Address
First Line	:	1618 S MILLENIUM WAY
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6439
Country	:	US
Telephone Number	:	208-884-3376
Fax Number	:	208-884-0858

Provider Business Practice Location Address
First Line	:	1618 S MILLENIUM WAY
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6439
Country	:	US
Telephone Number	:	208-884-3376
Fax Number	:	208-884-0858

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

Provider Enumeration Date	:	04/08/2015
Last Update Date	:	05/18/2026

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