Keller, Wade Robert
Keller, Wade Robert is an individual health care provider with primary practice located at 1605 E Riverside Dr , Eagle ID 83616-6237. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Keller, Wade Robert can be contacted via phone (208) 939-6227.Contact Information
Primary practice address
1605 E Riverside Dr
Eagle ID 83616-6237
Phone: (208) 939-6227
Fax: (208) 939-6442
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 4692 | Arizona |
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | O-0559 | Idaho |
Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | O-0559 | Idaho |
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | O-0559 | Idaho |
Profile Details
NPI number | 1942402169 |
---|---|
LBN Legal business name | Keller, Wade Robert |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 1st, 2007 |
Last updated | Nov 3rd, 2022 - about 2 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.
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