Individual
KEITH VAN ALLEN NANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 783-3286
(919) 783-3363
Mailing address
PO BOX 100559, FLORENCE, SC 29501-0559
(843) 664-4300
(843) 664-4308
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
31052
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
31052
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61786
BCBS
NC
05
—
8961786
—
NC
Enumeration date
02/28/2006
Last updated
01/15/2008
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