Individual
MICHAEL PAUL KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4351 E LOHMAN AVE STE 202, LAS CRUCES, NM 88011-8260
(575) 522-5955
(575) 522-6228
Mailing address
4351 E LOHMAN AVE STE 202, LAS CRUCES, NM 88011-8260
(575) 522-5955
(575) 522-6228
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2001231
NM
2086S0129X
Vascular Surgery Physician
Primary
2001231
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96339811
—
NM
Enumeration date
11/21/2005
Last updated
09/09/2020
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