Keller, Michael Randall
Keller, Michael Randall is an individual health care provider with primary practice located at 7330 N 99Th Ave Ste 325 , Glendale AZ 85307-3022. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Keller, Michael Randall can be contacted via phone (480) 398-7620.Contact Information
Primary practice address
7330 N 99Th Ave Ste 325
Glendale AZ 85307-3022
Phone: (480) 398-7620
Fax: (480) 398-7621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25190 | Arizona |
Profile Details
| NPI number | 1821062183 |
|---|---|
| LBN Legal business name | Keller, Michael Randall |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Jul 30th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821062183 | NPPES |
| Arizona | MEDICAID | 406521 |
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