Individual
GARY R KEILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 SUMMER ST, SUITE 230 S, WORCESTER, MA 01608-1312
(508) 368-3150
(508) 368-3152
Mailing address
630 PLANTATION ST, WORCESTER, MA 01605-2038
(508) 368-3150
(508) 368-3152
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
74084
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042472266
ONE HEALTH PLAN
—
01
—
0500193
EVERCARE
—
01
—
130015211
RAILROAD MEDICARE
—
01
—
1700170
CIGNA PAL ID
—
01
—
29203
CHILDRENS MEDICAL SECURIT
—
01
—
3118649
MEDICAID WELFARE
—
01
—
5845001
AETNA US HEALTHCARE
—
01
—
784035
MVP HEALTH CARE
—
01
—
917831
FIRST HEALTH
—
01
—
9900842
FALLON COMMUNITY HEALTH P
—
01
—
AA3016
HARVARD PILGRIM HEALTHCAR
—
01
—
J14372
BLUE CARE ELECT
—
Enumeration date
11/04/2005
Last updated
05/02/2011
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