Individual
KEITH WALTER MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
59 EXECUTIVE PARK SOUTH NE STE 3000, ATLANTA, GA 30329-2208
(404) 778-7000
Mailing address
59 EXECUTIVE PARK SOUTH NE STE 3000, ATLANTA, GA 30329-2208
(404) 778-1289
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
065709
GA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
65709
GA
Other
Enumeration date
05/04/2008
Last updated
03/30/2021
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