Individual
PATRICK KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
186 MEDICAL VILLAGE DR, NEWPORT, VT 05855-8537
(802) 334-3520
Mailing address
1878 MOUNTAIN ROAD, STOWE, VT 05672
(802) 253-4853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042-0010218
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00058268
BCBS
VT
01
—
080183802
TRAVELERS MEDICARE
VT
05
—
0VN2605
—
VT
01
—
3389370
CIGNA
VT
01
—
353937
MVP
VT
01
—
4653401
VERMONT MANAGED CARE APEX
VT
01
—
8000337
LADIES FIRST
VT
Enumeration date
09/29/2006
Last updated
04/30/2021
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