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Individual
MARC I KELLER
Active
Individual
MARC I KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02.0005602
VT
207RA0401X
Addiction Medicine (Internal Medicine) Physician
042.0005602
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004733
—
VT
05
—
30010121
—
NH
Enumeration date
08/11/2006
Last updated
04/01/2020
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