Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101049750 | VA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0101049750 | VA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 0101049750 | VA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | D62075 | MD |
NPI | 1811967292 |
---|---|
Provider Name | Dr. David J. Keblish |
First Address | Annapolis, MD 21401-3742 |
Second Address | Annapolis, MD 21401-3742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 15/07/2015 |