Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD041442 | DC |
N | 207KA0200X | Allergist | D75965 | MD |
NPI | 1174724405 |
---|---|
Provider Name | Dr. Michael Daniel Keller |
First Address | Baltimore, MD 21297-3215 |
Second Address | Washington, DC 20010-2916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 15/08/2013 |