Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD13425 | RI |
NPI | 1083613244 |
---|---|
Provider Name | Dr. Martin Keszler |
First Address | Providence, RI 02905-2499 |
Second Address | Providence, RI 02905-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 10/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MK82346 | (05) | RI |