Individual
DR. KEITH B CHURCHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 YORK ST, TOMPKINS 106, NEW HAVEN, CT 06510-3220
(615) 688-2610
Mailing address
20 YORK ST, TOMPKINS 106, NEW HAVEN, CT 06510-3220
(203) 688-2610
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
054404
CT
207RC0000X
Cardiovascular Disease Physician
25554
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3083503
—
TN
Enumeration date
08/12/2006
Last updated
06/24/2016
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