Individual
KEITH R MCINTYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.P.
Contact information
Practice address
10755 FALLS RD, LUTHERVILLE, MD 21093-4515
(410) 583-2970
Mailing address
PO BOX 64474, BALTIMORE, MD 21264-4474
(410) 933-7400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R086452
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
356803200
—
MD
Enumeration date
05/08/2006
Last updated
01/17/2014
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