Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 2017-01022 | NC |
N | 208D00000X | General Practice Physician | 0101244033 | VA |
NPI | 1023135894 |
---|---|
Provider Name | Dr. Brian Michael Keuski |
First Address | Rehoboth Beach, DE 19971-8615 |
Second Address | Portsmouth, VA 23708-2111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2007 |
Last Update Date | 10/09/2021 |