Wade Robert Keller in Eagle - Dermatology
Wade Robert Keller - NPI 1942402169
Wade Robert Keller is a Dermatology in Eagle, Idaho. Wade Robert Keller practices all healthcare services and medical treatments related to Dermatology. The NPI Number for Wade Robert Keller is 1942402169. The last update date is 2022-11-03.
Wade Robert Keller's current location address is 1605 E Rverside Drive, Eagle, Idaho. You can contact this provider via phone number 2089396227 and fax number 2089396442. The mailing address for Wade Robert Keller is 1605 E Rverside Drive, Eagle, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wade Robert Keller |
|---|---|
| Address | 1605 E Rverside Drive, Eagle, Idaho |
| Phone Number | 2089396227 |
| Fax Number | 2089396442 |
| Sole Proprietor | N |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1942402169 |
|---|---|
| Provider Enumeration Date | 2007-06-01 |
| Last Updated Date | 2022-11-03 |
Provider Mailing Address Detail
| Address | 1605 E Rverside Drive |
|---|---|
| City | Eagle |
| State | Idaho (ID) |
| Post Code | 83616 |
| Phone Number | 2089396227 |
| Fax Number | 2089396442 |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | 4692 |
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Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
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What is the unique 10-digit identifier code assigned to Wade Robert Keller by the Centers for Medicare & Medicaid Services?
The Wade Robert Keller has been issued the NPI (National Provider Identifier) 1942402169 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Wade Robert Keller is physically located?
The Wade Robert Keller is physically situated at the following address: 1605 E Rverside Drive, Eagle, ID, 83616.
What is Wade Robert Keller's specialized field of practice, and what is the corresponding taxonomy classification code?
The Wade Robert Keller's area of specialization is Dermatology, and the corresponding taxonomy code that categorizes this field of practice is 207N00000X.
When was the Wade Robert Keller's 1942402169 issued?
The Wade Robert Keller's 1942402169 was issued on 2007-06-01.
When was the information regarding Wade Robert Keller, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Wade Robert Keller, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2022-11-03.