Individual
KEITH MATTHEW WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2945 HAZELWOOD ST STE 200, MAPLEWOOD, MN 55109-1243
(612) 232-7800
Mailing address
2945 HAZELWOOD ST STE 200, MAPLEWOOD, MN 55109-1243
(612) 232-7800
(651) 326-8770
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
61495
MN
Other
Enumeration date
04/15/2014
Last updated
08/07/2023
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