Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 29289 | MN |
NPI | 1801887054 |
---|---|
Provider Name | Mary U Keating |
First Address | Saint Cloud, MN 56303-5000 |
Second Address | Saint Cloud, MN 56303-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 28/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0212393 | MEDICA HEALTH PLANS (01) | |
110410 | UCARE (01) | |
2116568 | FIRST HEALTH PLAN (01) | |
254015 | PREFERRED ONE (01) | |
51A35KE | BLUE CROSS BLUE SHIELD (01) | |
598519 | ARAZ GROUP AMERICAS PPO (01) | |
599500400 | MEDICAL ASSISTANCE (01) | |
AK3240289 | DEA (01) | MN |
E64674 | (02) | |
HP25465 | HEALTH PARTNERS (01) |