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Individual
DR. CANDACE KELLER
Active
Individual
DR. CANDACE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
08368
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050000792
—
MS
01
—
201397813A
BCBS
MS
01
—
P00462245
RAILROAD MEDICARE
MS
01
—
P01236761
RAILROAD MEDICARE PTAN
MS
Enumeration date
04/26/2006
Last updated
01/07/2014
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