Individual
JEAN KELLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
601 N CAROLINE ST, BALTIMORE, MD 21287-0006
(410) 955-6700
Mailing address
PO BOX 64313, BALTIMORE, MD 21264-4313
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C00855
MD
Other
Enumeration date
06/09/2006
Last updated
07/08/2007
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