Individual
DR. BOWEN ELIOT KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 OSBORNE RD NE, FRIDLEY, MN 55432-2718
(763) 236-5000
(763) 236-3524
Mailing address
550 OSBORNE RD NE, FRIDLEY, MN 55432-2718
(763) 572-5710
(763) 571-3008
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40560
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0413830
MEDICA
MN
01
—
1017337
PREFERRED ONE
MN
01
—
124494
UCARE
MN
05
—
476817500
—
MN
01
—
5366669
AETNA
MN
01
—
55Q07KE
BCBS OF MN
MN
01
—
779466
AMERICA'S PPO
MN
01
—
HP26738
HEALTHPARTNERS
MN
Enumeration date
04/19/2006
Last updated
03/11/2021
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