Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 71775 | MA |
N | 208600000X | Surgeon | 71775 | MA |
Y | 2086S0129X | Vascular Surgeon | 71775 | MA |
NPI | 1053367128 |
---|---|
Provider Name | Stephen Leighton Keith |
First Address | Dartmouth, MA 02747-1242 |
Second Address | Dartmouth, MA 02747-1242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 08/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9767797 | (05) | MA |
F33448 | (02) | MA |