Individual
DR. MARTIN MARK KEIBEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
574 MIDDLE TPKE E, MANCHESTER, CT 06040-3730
(860) 646-4334
(860) 646-7020
Mailing address
574 MIDDLE TPKE E, MANCHESTER, CT 06040-3730
(860) 646-4334
(860) 646-7020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
023567
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00064445
MEDICARE RR
CT
Enumeration date
08/07/2006
Last updated
10/31/2007
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